Mental health literacy, stigma and attitudes towards seeking help in Malta

Abstract

Even though mental health services are widely available, only one-third of individuals with a known mental health illness seek professional help. Two major barriers are stigma and poor mental health literacy (MHL). 45.7% of the Maltese adult population quantified poor MHL, which was named as one of the barriers to seeking help in Malta. While stigma was indicated to be hindering every aspect in lives of Maltese with mental health illnesses. The primary aim of this research is to identify the relationship between MHL, stigma and attitudes towards seeking help among Maltese adults living in Qormi by utilising a triangulation of methods. Literature available formulated three hypotheses for this study: i. Individuals with higher levels of non-stigmatising attitudes are more likely to seek help ii. People having higher MHL are more likely to seek help iii. Adults with higher MHL are more likely to have less stigmatising attitudes This research utilised a cross-sectional design in the quantitative component. An adapted version of the Mental Health Literacy Scale (MHLS) was utilised as a study tool amongst 201 adults living in Qormi. The four qualitative component participants were recruited from Qormi Mental Health Clinic (QMHC) through a gate keeper, utilising a purposeful sampling technique. Each participant in both components was given an information sheet and a consent form in either English or Maltese, to consent their participation in the study. Surveys in the quantitative component were analysed through a variety of tests in SPSS, namely the Shapiro-Wilk test, the Spearman Correlation test and the Kruskal Wallis test. While semi-structured interviews in the qualitative component were analysed through thematic analysis. Findings from quantitative component revealed a positive and significant relationship between MHL, non-stigmatising attitudes and attitudes towards seeking help. Qualitative findings support the quantitative findings as participants expressed how lack of MHL had influenced their journey to prolong seeking help and influences stigmatising attitudes as mental health is still considered a taboo. Participants also conveyed how stigma impacts them or others leading to a prolonged time to seek help. Ultimately, participants emphasised the importance of awareness to increase MHL, in order to reduce stigma and facilitate help-seeking behaviours. Another interesting aspect which resulted from the qualitative component was trivialisation and/or displacement of mental health problems, which also lead to prolonged time in seeking help. The research findings together with literature accepted all three hypotheses. Thus, various recommendations were put forward by the researcher and qualitative participants to increase MHL and non-stigmatising attitudes, while facilitating help seeking behaviours. This can be achieved by introducing MHL educational programmes in schools, implementing policies and amalgamating envisaged actions in the Mental Health Strategy, amongst others.