The Assessment of the Quality of Mental Health Literacy Measurement Tools: A Scoping Review and Three Systematic Reviews
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BACKGROUND Mental health literacy interventions have received increasing attention as a strategy to promote positive mental health, improve early identification of mental disorders, reduce stigma and enhance help-seeking behaviors. However, despite the abundance of research on mental health literacy interventions, there is an absence of evaluations of current available mental health literacy measures. This research responds to this need through a scoping review and three systematic reviews on the scope and quality of mental health literacy measurement tools. METHODS We searched PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, and ERIC for relevant studies without limits on study participants, locations, or publication dates. Searches and analysis were conducted between 2013 and 2016. We included English publications of quantitative studies addressing psychometrics of mental health literacy tools. We hand-searched reference lists of included studies and additionally searched Google Scholar for additional studies. We assessed the methodological quality of included studies, the quality of each measurement property, and determined the overall level of evidence for measurement properties across studies. RESULTS We included 16 knowledge tools (17 studies), 101 stigma tools (117 studies), and 12 help-seeking related tools (24 studies) for assessment. We found that knowledge measures mainly investigated the ability of illness identification, and factual knowledge of mental disorders. Stigma measures addressed personal/perceived stigma against mental illness, self-stigma, experienced stigma; and stigma against mental health care. Help-seeking measures assessed help-seeking attitudes, intentions to seek help, and actual help-seeking behaviors. Thirteen mental health knowledge tools, 11 help-seeking tools, and 81 stigma measurement tools were rated as having “limited”, “moderate” or “strong” level of evidence. The level of evidence for the rest of the tools were considered as “conflicting” or “unknown”. CONCLUSIONS This research provides a compendium of available mental health literacy measures with their quality assessed. Future research may focus on the generalizability of the tools across diverse settings, follow standard guidelines to improve the quality of future psychometrics studies, and may develop and test mental health literacy interventions based on the findings of this research. However, the validation of measurement tools is an ongoing process and additional research may consolidate our recommendations.