Mental health literacy

A picture showing the variety of mental health illnesses.

Mental health literacy has been defined as "knowledge and beliefs about mental disorders which aid their recognition, management and prevention. Mental health literacy includes the ability to recognize specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments, and of professional help available; and attitudes that promote recognition and appropriate help-seeking".[1] The concept of mental health literacy was derived from health literacy, which aims to increase patient knowledge about physical health, illnesses, and treatments.[2]

Framework

[edit]

Mental health literacy has three major components: recognition, knowledge, and attitudes. A conceptual framework of mental health literacy illustrates the connections between components, and each is conceptualized as an area to target for measurement or intervention.[2][3][4] While some researchers have focused on a single component, others have focused on multiple and/or the connection between components. For example, a researcher may focus solely on improving recognition of disorders through an education program, whereas another researcher may focus on integrating all three components into one program.[citation needed]

Recognition

[edit]

Recognition can be broken down into symptom or illness recognition. Symptom recognition is the ability to detect beliefs, behaviors, and other physical manifestations of mental illness, without knowing explicitly which disorder they link to. Specific illness recognition is the ability to identify the presentation of a disorder, such as major depressive disorder.[citation needed]

It relates to my article because it defines the mental health needs to be taken seriously

The recognition of difference between knowledge and attitudes is a crucial part of the mental health literacy framework. While some efforts have focused on promoting knowledge, other researchers have argued that changing attitudes by reducing stigma is a more prolific way of creating meaningful change in mental healthcare utilization. Overall, both approaches have benefits for improving outcomes.[5]

Knowledge

[edit]

Knowledge is the largest component of mental health literacy, and important topics in Mental Health include:

  • How to get information: the networks and systems individuals use to get information about mental disorders. This may include friends, family, educators, or broader sources, such as entertainment or social media.
  • Risk factors: what factors put individuals at greatest risk for specific mental health disorders. Risk factors can be unemployment, low income, lack of education, discrimination, and violence.[6]
  • Causes of mental disorders
  • Self-treatment or self-help: what are the best individuals can do to help themselves recover without consulting with professionals, including the use of self-help books and media. Although many self- treatments are quite ineffective and even harmful due to lack of knowledge.[7]
  • Professional help: where to get professional help and/or what professional help is available.

Attitudes

[edit]

Attitudes are studied in two sub-components: attitudes about mental disorders, or persons with mental disorders, and attitudes about seeking professional help or treatment. Attitudes can vary greatly by individual, and can often be difficult to measure or target with intervention. Nonetheless, a large body of research literature exists on both sub-components, though not always explicitly tied to the mental health literacy.[8]

Recent research recognizes the varying attitudes across mental health professionals towards prognosis, long-term outcomes and likelihood of discrimination as more negative than those of the public. The attitudes of mental health professionals also differ towards interventions, but this variability is usually related to professional orientation.[9]

Public outlook

[edit]

Surveys of the public have been carried out in a number of countries to investigate mental health literacy.[10][11][12][13][14][15][16] These surveys demonstrate that the recognition of mental disorders is lacking and reveal negative beliefs about some standard psychiatric treatments, particularly medications. On the other hand, psychological, complementary and self-help methods are viewed much more positively. The public tends to prefer self-help and lifestyle interventions, opposed to medical, and psychopharmacological interventions.[9]

Implications surrounding public attitudes towards mental disorders include negative Stereotypes, Prejudice, or Stigma. As a result, this can influence help-seeking behavior or failure to seek treatment.[9] In Canada, a national survey found that young adult males tend to manage their problems individually and are less likely to seek formal help.[17] Media influence plays a huge role in perpetuating negative mindsets towards mental illness, such as prescribing menacing qualities. A recent study highlights how the majority of participants note the media as the primary source of their beliefs about mental illness being associated with violence, and how this attitude is more prevalent towards serious mental illnesses.[9] Fear and perceptions of danger related to mental illness have increased over the past few decades, largely due to serious mental illness such as schizophrenia being associated as potentially violent and harmful to others.[9] These beliefs and attitudes are potential barriers to seeking individual professional help, and being supportive of others.

Additionally, the negative stigma against mental health may impede the ability of some to get help. When a caregiver avoids seeking mental health treatment due to fear of the stigma surrounding the label of a mental illness, it is seen as affiliate stigma.[18] This phenomenon is exacerbated in scenarios where children who present with signs of mental illness have parents who hold negative beliefs about mental illness. Studies found that individuals that have a negative impression of mental health labels might refuse seeking treatment for themselves or their children in order to avoid mental illness label.[19] A study in 2015 found that affiliate stigma decreases a parent's willingness to pursue mental health treatment for their children, which can lead to decreases in overall well-being for children.[20] This same study found that some parents fear that general practitioners will judge them as bad parents if their children are diagnosed with ADHD. A case study from a supplement to the 2001 US Surgeon General’s report on mental health in America shows an example of low mental health literacy and/or fear of the stigma of mental illness: "An was a 30-year-old bilingual, Vietnamese male who was placed in involuntary psychiatric hold for psychotic disorganization. After neighbors found him screaming and smelling of urine and feces, they called the police, who escorted him to a psychiatric emergency room… His parents had a poor understanding of schizophrenia and were extremely distrustful of mental health providers. They thought that his psychosis was caused by mental weakness and poor tolerance of the recent heat wave…These misconceptions and differences in beliefs caused the parents to avoid the use of mental health services"[21] Affiliate stigma and lack of mental health literacy can cause harm in those suffering from mental illness.

Military

[edit]

Along with schizophrenia, PTSD is also a highly stigmatized mental disorder that is often misunderstood, especially among the military community. Studies have found that there are various barriers to treatment that prevent many veterans from seeking treatment for PTSD and other mental disorders[22][23] such as concerns that others will see them as "crazy", beliefs that treatment is ineffective or is simply not worth it, and beliefs that those with mental health problems cannot be relied upon.[24] These beliefs about mental health and mental health treatment is more prevalent in the military community due to the culture of the military that places a strong emphasis on emotional toughness, self-control and stoicism.[25] Though these values are useful in combat scenarios, they can serve as barriers to seeking treatment and treatment adherence.[26]

Measures

[edit]

Researchers have measured aspects of mental health literacy in several ways.[4][27] Popular methodologies include vignette studies and achievement tests. Vignette studies measure mental health literacy by providing a brief, detailed story of an individual (or individuals) with a mental health problem, and ask participants questions to identify what problem the individual is experiencing, and at times, additional questions about how the individual can help themselves.[2]

Achievement tests measure mental health literacy on a continuum, such that higher scores on a test indicate greater overall knowledge or understanding of a concept. Achievement tests can be formatted using multiple-choice, true/false, or other quantitative scales.[citation needed]

Various scales have been created to measure the various components of mental health literacy, though not all are validated.[4][27] Mental health literacy has been measured across several populations, varying in age range, culture, and profession. Most studies have focused on adult and young adult populations, though improving literacy in children has been a focus of prevention efforts.

Parental label avoidance can be measured by the Self-Stigma of Seeking Help Scale (SSOSH).[28]

Family empowerment is measured by the Family Empowerment Scale (FES).[29]

Limitations

[edit]
A statue of a man deep in thought.

Low literacy within a population is a relevant concern, since at the most basic level, mental health literacy is linked to general literacy. Without this foundation, the beneficial effects of mental health literacy are challenging for those who face difficulties with reading and writing.[9] Increased measures to increase literacy rates must be employed to empower and encourage the self-help components of mental health literacy.[citation needed]

Populations can be diverse, which means barriers, such as cultural and social contexts, must be addressed. Within and across cultures, social, economic and political factors profoundly influence mental health.[30] There are numerous environmental and socioeconomic determinants of mental health and mental illness, just as there are for physical health and physical illness.[9] Social determinants of physical health including poverty, education and social support also serve as influencers.[9] In order to encompass mental health literacy and diverse perspectives, further research in these areas are needed.

Recognizing uncommon mental disorders is another hurdle that can disrupt mental health literacy within the public. Recent research shows that most studies are limited to identifying depression, generalized anxiety, and schizophrenia. In a recent Canadian study, most participants demonstrated good mental health literacy in regards to most mental health disorders, but a poor understanding of panic disorder.[31] An increased awareness surrounding underrepresented or more uncommon mental disorders is needed to widen public knowledge.[citation needed]

A concluding limitation is the lack of research on child mental health literacy, as the majority of studies focus on adults and adolescents. If caregivers are not educated on recognizing and supporting mental disorders, this could create confusion and result in delayed treatment or wrongful prognosis for dependents. A child mental health literacy (CMHL) initiative could be implemented to target all adults in the general population, as well as parents, teachers, health professionals and/or children themselves.[32]

Improvement approaches

[edit]

A number of approaches have been tried and suggested to improve mental health literacy, many of which have evidence of effectiveness. These include:

  1. Whole of community campaigns. Examples are beyondblue[33] and the Compass Strategy[34] in Australia, the Defeat Depression Campaign[35] in the United Kingdom, and the Nuremberg Alliance Against Depression[36] in Germany.
  2. School-based interventions. These include MindMatters[37] and Mental Illness Education[38] in Australia, and the Mental Health & High School Curriculum Guide in Canada[39]
  3. Individual training programs. These include mental health first aid training[40] and training in suicide prevention skills.[41] Initiatives that encourage empowerment and choice would also be beneficial, such as web-based self-directed therapy.[9]
  4. Websites and books aimed at the public. There is evidence that both websites and books can improve mental health literacy.[42][43] However, the quality of information on websites can sometimes be low.[44]
  5. Rapport between mental health professionals and clients. By creating a partnership, professionals can promote competence, informed choice, and comprehensible knowledge for all levels of understanding, such as translating research findings into simpler language.[9]

Family empowerment

[edit]

Children often must rely on their families in order to access mental health services leading to parents receiving an increasing amount of attention from mental health professionals in order to educate them on mental health. The status of family empowerment (FE) is composed of two dimensions: (a) levels of empowerment (family, knowledge, system and community) and (b) the manor that empowerment is expressed (such as attitudes, knowledge and behaviors).[45][29] Studies have shown that FE is positively associated with healthy child functioning.[46][47] FE also deals with an individual's belief in their ability to execute behaviors necessary to produce specific performance attainments, also called self-efficacy,[48] specifically regarding attaining knowledge of mental health. A study conducted in 2022 found that increased parent self-efficacy regarding mental health is positively correlated with child well-being outcomes.[49]

Sports

[edit]

Mental health literacy has also found its uses in the realm of sports. Sports social workers are promoting mental health literacy of athletes through various means. Social workers are engaging in research, education, policy development, advocating for individuals, organizing communities, and through direct practice.[50]

See also

[edit]

References

[edit]
  1. ^ Jorm, A.F.; Korten, A.E.; Jacomb, P.A.; Christensen, H.; Rodgers, B.; Pollitt, P. (1997). ""Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment". Medical Journal of Australia. 166 (4): 182–186. doi:10.5694/j.1326-5377.1997.tb140071.x. PMID 9066546. S2CID 24516524.
  2. ^ a b c Jorm, Anthony F.; Korten, Ailsa E.; Jacomb, Patricia A.; Christensen, Helen; Rodgers, Bryan; Pollitt, Penelope (1997-01-01). "Mental health literacy: a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment". Medical Journal of Australia. 166 (4): 182–186. doi:10.5694/j.1326-5377.1997.tb140071.x. ISSN 0025-729X. PMID 9066546. S2CID 24516524.
  3. ^ Jorm, Anthony F. (2000). "Mental health literacy: Public knowledge and beliefs about mental disorders" (PDF). British Journal of Psychiatry. 177 (5): 396–401. doi:10.1192/bjp.177.5.396. PMID 11059991.
  4. ^ a b c O'Connor, Matt; Casey, Leanne; Clough, Bonnie (2014-08-01). "Measuring mental health literacy – a review of scale-based measures". Journal of Mental Health. 23 (4): 197–204. doi:10.3109/09638237.2014.910646. hdl:10072/61844. ISSN 0963-8237. PMID 24785120. S2CID 207499012.
  5. ^ Corrigan, Patrick W.; Morris, Scott B.; Michaels, Patrick J.; Rafacz, Jennifer D.; Rüsch, Nicolas (2012). "Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies". Psychiatric Services. 63 (10): 963–973. doi:10.1176/appi.ps.201100529. PMID 23032675.
  6. ^ McDowell, Michal J.; Hughto, Jaclyn M. W.; Reisner, Sari L. (December 2019). "Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults". BMC Psychiatry. 19 (1): 16. doi:10.1186/s12888-018-2008-0. ISSN 1471-244X. PMC 6327526. PMID 30626372.
  7. ^ Guy, Sarah; Sterling, Bobbie Sue; Walker, Lorraine O.; Harrison, Tracie C. (2014). "Mental Health Literacy and Postpartum Depression: A Qualitative Description of Views of Lower Income Women". Archives of Psychiatric Nursing. 28 (4): 256–262. doi:10.1016/j.apnu.2014.04.001. PMID 25017559.
  8. ^ Guy, Sarah; Sterling, Bobbie Sue; Walker, Lorraine O.; Harrison, Tracie C. (2014). "Mental Health Literacy and Postpartum Depression: A Qualitative Description of Views of Lower Income Women". Archives of Psychiatric Nursing. 28 (4): 256–262. doi:10.1016/j.apnu.2014.04.001. PMID 25017559.
  9. ^ a b c d e f g h i j Canadian Alliance on Mental Illness and Mental Health, "Mental health literacy", 2007
  10. ^ Angermeyer, M.C.; Matschinger, H. (2005). "Have there been any changes in the public's attitudes towards psychiatric treatment? Results from representative population surveys in Germany in the years 1990 and 2001". Acta Psychiatrica Scandinavica. 111 (1): 68–73. doi:10.1111/j.1600-0447.2004.00441.x. PMID 15636596. S2CID 19933846.
  11. ^ Jorm, A.F., Nakane, Y., Christensen, H., Yoshioka, K., Griffiths, K.M. & Wata, Y. (2005). Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan. BMC Medicine, 3, 12. Open access icon
  12. ^ Jorm, A.F., Angermeyer, M. & Katschnig, H. (2000). Public knowledge of and attitudes to mental disorders: A limiting factor in the optimal use of treatment services. In G. Andrews & A.S. Henderson (Eds.) Unmet Need in Psychiatry. (pp. 399-413). Cambridge: Cambridge University Press.
  13. ^ Lauber, C.; Nordt, C.; Falcato, L.; Rössler, W. (2003). "Do people recognise mental illness? Factors influencing mental health literacy". European Archives of Psychiatry and Clinical Neuroscience. 253 (5): 248–251. doi:10.1007/s00406-003-0439-0. PMID 14504994. S2CID 24884202.
  14. ^ Magliano, L.; Fiorillo, A.; De Rosa, C.; Malangone, C.; Maj, M. (2004). "Beliefs about schizophrenia in Italy: A comparative nationwide survey of the general public, mental health professionals, and patients' relatives". Canadian Journal of Psychiatry. 49 (5): 322–330. doi:10.1177/070674370404900508. PMID 15198469.
  15. ^ Wang, J.L.; Adair, C.; Fick, G.; Lai, D.; Evans, B.; Perry, B.W.; Jorm, A.; Addington, D. (2007). "Depression literacy in Alberta: Findings from a general population sample". Canadian Journal of Psychiatry. 52 (7): 442–449. doi:10.1177/070674370705200706. PMID 17688008.
  16. ^ Marie, D., Forsyth, D. & Miles, L.K. (2004). Categorical ethnicity and mental health literacy in New Zealand. Ethnicity and Health, 9(3), 225-252.
  17. ^ Marcus, Madalyn; Westra, Henny (April 2012). "Mental Health Literacy in Canadian Young Adults: Results of a National Survey". Canadian Journal of Community Mental Health. 31 (1): 1–15. doi:10.7870/cjcmh-2012-0002. ISSN 0713-3936.
  18. ^ Ben-Zeev, Dror; Young, Michael A.; Corrigan, Patrick W. (October 2010). "DSM-V and the stigma of mental illness". Journal of Mental Health. 19 (4): 318–327. doi:10.3109/09638237.2010.492484. ISSN 0963-8237. PMID 20636112. S2CID 9662476.
  19. ^ Sayal, Kapil; Tischler, Victoria; Coope, Caroline; Robotham, Sarah; Ashworth, Mark; Day, Crispin; Tylee, Andre; Simonoff, Emily (December 2010). "Parental help-seeking in primary care for child and adolescent mental health concerns: qualitative study". British Journal of Psychiatry. 197 (6): 476–481. doi:10.1192/bjp.bp.110.081448. ISSN 0007-1250. PMID 21119154.
  20. ^ Chang, Chih-Cheng; Su, Jian-An; Tsai, Ching-Shu; Yen, Cheng-Fang; Liu, Jiun-Horng; Lin, Chung-Ying (June 2015). "Rasch analysis suggested three unidimensional domains for Affiliate Stigma Scale: additional psychometric evaluation". Journal of Clinical Epidemiology. 68 (6): 674–683. doi:10.1016/j.jclinepi.2015.01.018. PMID 25748074.
  21. ^ "Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health A Report of the Surgeon General". PsycEXTRA Dataset. 2001. doi:10.1037/e415842005-001. hdl:1903/22834. Retrieved 2023-03-15.
  22. ^ Elbogen, Eric B.; Wagner, H. Ryan; Johnson, Sally C.; Kinneer, Patricia; Kang, Han; Vasterling, Jennifer J.; Timko, Christine; Beckham, Jean C. (February 2013). "Are Iraq and Afghanistan Veterans Using Mental Health Services? New Data From a National Random-Sample Survey". Psychiatric Services. 64 (2): 134–141. doi:10.1176/appi.ps.004792011. ISSN 1075-2730. PMC 3622866. PMID 23475498.
  23. ^ Erbes, Christopher; Westermeyer, Joseph; Engdahl, Brian; Johnsen, Erica (April 2007). "Post-Traumatic Stress Disorder and Service Utilization in a Sample of Service Members from Iraq and Afghanistan". Military Medicine. 172 (4): 359–363. doi:10.7205/MILMED.172.4.359. ISSN 0026-4075. PMID 17484303. S2CID 40545836.
  24. ^ Hoge, Charles W.; Auchterlonie, Jennifer L.; Milliken, Charles S. (2006-03-01). "Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan". JAMA. 295 (9): 1023–1032. doi:10.1001/jama.295.9.1023. ISSN 0098-7484. PMID 16507803.
  25. ^ Krill Williston, Sarah; Roemer, Lizabeth; Vogt, Dawne S (June 2019). "Cultural and service factors related to mental health beliefs among post-9/11 veterans". International Journal of Social Psychiatry. 65 (4): 313–321. doi:10.1177/0020764019842327. ISSN 0020-7640. PMID 30995148. S2CID 121315415.
  26. ^ Resick, Patricia A.; Monson, Candice M.; Chard, Kathleen M. (2008). "Cognitive Processing Therapy Veteran/Military Version: Therapist's manual". PsycEXTRA Dataset. doi:10.1037/e514742018-001. Retrieved 2022-12-01.
  27. ^ a b Wei, Yifeng; McGrath, Patrick J.; Hayden, Jill; Kutcher, Stan (2015-01-01). "Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review". BMC Psychiatry. 15: 291. doi:10.1186/s12888-015-0681-9. ISSN 1471-244X. PMC 4650294. PMID 26576680.
  28. ^ Vogel, D. L.; Wade, N. G.; S., Haake (2006). "Measuring the self-stigma associated with seeking psychological help" (PDF). Journal of Counseling Psychology. 53 (3): 325–337. doi:10.1037/0022-0167.53.3.325.
  29. ^ a b Singh, Nirbhay N. (March 1995). "In search of unity: Some thoughts on family-professional relationships in service delivery systems". Journal of Child and Family Studies. 4 (1): 3–18. doi:10.1007/BF02233951. ISSN 1062-1024. S2CID 144094360.
  30. ^ Edmonds, David Matthew; Zayts-Spence, Olga; Fortune, Zoe; Chan, Angus; Chou, Jason Shang Guan (2024-03-04). "A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions". BMJ Open. 14 (3): e076729. doi:10.1136/bmjopen-2023-076729. PMC 11146370. PMID 38443080.
  31. ^ Catherine E. Gallagher & Margo C. Watt, "Mental Health Literacy in a Sample of Canadian Adults", 2019
  32. ^ Lucy A Tully , David J Hawes, Frances L Doyle , Michael G Sawyer, and Mark R Dadds, "A national child mental health literacy initiative is needed to reduce childhood mental health disorders", 2019
  33. ^ Jorm, A.F.; Christensen, H.; Griffiths, K.M. (2005). "The impact of beyondblue: the national depression initiative on the Australian public's recognition of depression and beliefs about treatments". Australian and New Zealand Journal of Psychiatry. 39 (4): 248–254. doi:10.1080/j.1440-1614.2005.01561.x. PMID 15777361. S2CID 182108464.
  34. ^ Wright, A.; McGorry, P.D.; Harris, M.G.; Jorm, A.F.; Pennell, K. (2006). "Development and evaluation of a youth mental health community awareness campaign: The Compass Strategy". BMC Public Health. 6: 215. doi:10.1186/1471-2458-6-215. PMC 1564138. PMID 16923195.
  35. ^ Paykel, E.S.; Hart, D.; Priest, R.G. (1998). "Changes in public attitudes to depression during the Defeat Depression Campaign". British Journal of Psychiatry. 173 (6): 519–522. doi:10.1192/bjp.173.6.519. PMID 9926082. S2CID 21172113.
  36. ^ Hegerl, U.; Althaus, D.; Stefanek, J. (2003). "Public attitudes towards treatment of depression: Effects of an information campaign". Pharmacopsychiatry. 36 (6): 288–291. doi:10.1055/s-2003-45115. PMID 14663652.
  37. ^ MindMatters Evaluation Consortium (2000). Report of the MindMatters (National Mental Health in Schools Project) Evaluation Project, vols 1-4. Newcastle: Hunter Institute of Mental Health.
  38. ^ Rickwood, D.; Cavanagh, S.; Curtis, L.; Sakrouge, R. (2004). "Educating young people about mental health and illness: Evaluating a school-based programme". International Journal of Health Promotion. 6 (4): 23–32. doi:10.1080/14623730.2004.9721941. S2CID 71641990.
  39. ^ Kutcher, S.; Wei, Y.; McLuckie, A.; Bullock, L. (2013). "Educator mental health literacy: a programme evaluation of the teacher training education on the mental health & high school curriculum guide". Advances in School Mental Health Promotion. 6 (2): 83–92. doi:10.1080/1754730X.2013.784615. S2CID 57945985.
  40. ^ Kitchener, B.A.; Jorm, A.F. (2006). "Mental Health First Aid training: review of evaluation studies". Australian and New Zealand Journal of Psychiatry. 40 (1): 6–8. doi:10.1080/j.1440-1614.2006.01735.x. hdl:1885/23864. PMID 16403032. S2CID 208640220.
  41. ^ Pearce, K., Rickwood, D. & Beaton, S. (2003). Preliminary evaluation of a university-based suicide intervention project: Impact on participants. Australian e-Journal for the Advancement of Mental Health, 2, www.auseinet.com/journal/vol2iss1/Pearce.pdf.
  42. ^ Christensen, H.; Griffiths, K.M.; Jorm, A.F. (2004). "Delivering interventions for depression by using the internet: randomised controlled trial". British Medical Journal. 328 (7434): 265. doi:10.1136/bmj.37945.566632.ee. PMC 324455. PMID 14742346.
  43. ^ Jorm, A.F.; Griffiths, K.M.; Christensen, H.; Korten, A.E.; Parslow, R.A.; Rodgers, B. (2003). "Providing information about the effectiveness of treatment options to depressed people in the community: A randomized controlled trial of effects on mental health literacy, help-seeking and symptoms". Psychological Medicine. 33 (6): 1071–1087. doi:10.1017/s0033291703008079. PMID 12946091. S2CID 34781234.
  44. ^ Griffiths, K.M.; Christensen, H. (2002). "The quality and accessibility of Australian depression sites on the World Wide Web". Medical Journal of Australia. 176 (10): S97–S104. doi:10.5694/j.1326-5377.2002.tb04509.x. PMID 12065004. S2CID 23306.
  45. ^ Koren, Paul E.; DeChillo, Neal; Friesen, Barbara J. (1992). "Measuring empowerment in families whose children have emotional disabilities: A brief questionnaire". Rehabilitation Psychology. 37 (4): 305–321. doi:10.1037/h0079106. ISSN 1939-1544.
  46. ^ Resendez, Miriam G.; Quist, Ryan M.; Matshazi, Dumiso G. M. (2000-12-01). "A Longitudinal Analysis of Family Empowerment and Client Outcomes". Journal of Child and Family Studies. 9 (4): 449–460. doi:10.1023/A:1009483425999. ISSN 1573-2843. S2CID 140968342.
  47. ^ Onwumere, Juliana; Kuipers, Elizabeth (2018-09-01). "Psychosis and the family: the role of family interventions". In Howes, Oliver (ed.). Treatment Response and Resistance in Schizophrenia. doi:10.1093/med/9780198828761.003.0010. ISBN 9780198828761.
  48. ^ "Teaching Tip:Self-Efficacy". APA.org. Retrieved 2022-12-02.
  49. ^ Kosyluk, Kristin; Kenneally, Ryan G.; Tran, Jennifer T.; Cheong, Yuk Fai; Bolton, Cassidy; Conner, Kyaien (November 2022). "Overcoming stigma as a barrier to children's mental health care: The role of empowerment and mental health literacy". Stigma and Health. 7 (4): 432–442. doi:10.1037/sah0000402. ISSN 2376-6964. S2CID 251167917.
  50. ^ Moore, Matt A; Gorczynski, Paul; Miller Aron, Cindy (2022-06-20). "Mental Health Literacy in Sport: The Role of the Social Work Profession". Social Work. 67 (3): 298–300. doi:10.1093/sw/swac022. ISSN 0037-8046. PMID 35554606.