Mental health literacy in iran: an urgent need for a remedy.

Mental health is considered as one of the fundamental criteria of evaluating a specific society and there is no doubt that it plays a key role in its efficiency and also its advancement. Mental health refers to a broad range of activities related to the mental well-being component directly or indirectly, covered in the World Health Organization (WHO) definition of health: “A state of complete physical, mental and social well-being and not merely the absence of disease.”[1] The loss of mental health causes disorders comprise a broad range of problems, with different symptoms that are generally characterized by some combination of abnormal thoughts, emotions, behaviors and relationships with others. Examples like depression, schizophrenia and disorders due to drug abuse, which most of them can be successfully treated.[2]

WHAT IS THE MENTAL HEALTH STATUS IN THE WORLD AND IRAN?

According to centers for disease control and prevention (CDC) findings, psychological diseases have been the most influential diseases that 450 million people in the world are suffering from.[3] Psychological diseases are the 4th from the five main diseases, which cause disability in the age group between 15 and 44 years. Psychological disorders are the reason for 30.8% of disability cases in all years of a lifetime that depression and anxiety are the most common of them.[4] According to the World Bank reports, depression has had a Disability adjusted Life Years (DALY) equal with 25% in Middle East and North of Africa countries and it is from the noticeable diseases considering priority of prevention and treatment.[56] These disorders have not only direct effects on causing disability and increasing early death (that causes loss of human capital in the society), but also influence on incidence, progress and prognosis in other diseases like drug abuse, tobacco, lack of physical activities that are a prelude of chronic diseases like high blood pressure, coronary artery disease and diabetes, which WHO, World Bank and CDC have mentioned to them as priorities in health subject.[356] On the other hand, according previous studies in this field, the psychological disorders have been highly prevalent in Iran and because of causing disability; it has the second rank for the burden of disease. This data reveals the importance and priority of paying to this problem in our country, more than before.[7] The positive point is the psychological disorders have possibilities for prevention, diagnosis and treatment and effective on time interventions can have a significant role in reducing the burden of disease and side-effects of it.[3]

WHAT IS THE MENTAL HEALTH LITERACY? DEFINITION AND IMPORTANCE

Health literacy definition by Canadian expert panel is “health literacy is the ability to access, understand, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course.”[8] Health literacy is considered as a set of individual abilities that enable them to get more information and also use them. These abilities are approximately stable along the time, although, it will be extended by educational programs or it can be reduced by aging or cognitive problem.[91011]

Mental health literacy is the “knowledge and beliefs about mental disorders, which aid their recognition, management and prevention.”[12] Mental health literacy has several components consist of: “(a) the ability to recognize specific disorders or different types of psychological distress; (b) knowledge and believes about risk factors and causes; (c) knowledge and believes about self-help interventions; (d) knowledge and believes about professional help available; (e) attitudes, which facilitates recognitions and appropriate help-seeking; and (f) knowledge of how to seek mental health information.”[13] Choosing the affluent and healthy life-style, knowing how to seek medical care and the advantages of using prevention services, require knowing information related to health and using it.[1415] People with lower level of health literacy use prevention services less and they refer to clinics only when they are sick.[16] Studies show that the cost of health costs is high in people with lower level of health literacy. Furthermore, the low-level of mental health can limit the optimal using of health services.[1718] Raising the mental health level along with decreasing the stigmas of all related aspects to this group of disorders can be effective in reducing the burden of disease stemming from them.

WHAT IS THE MENTAL HEALTH LITERACY STATUS IN DEVELOPING COUNTRIES CONSIST OF IRAN?

In developing countries, public knowledge about mental disorders as medical conditions is inaccurately understood. It seems that improving the mental health literacy among primary health-care professionals is necessary. Poor mental health literacy is a barrier to providing treatment for those who need and is of particular concern in low and middle-income countries like Iran.[19] This subject is focused in Iran, considering the mental health plan and introducing mental health literacy as one of the 10 key subjects in mental health, also mental health literacy promotion in different groups of society as one of the health ministry three basic strategies in the next 5 years.[7] Despite this fact, no comprehensive research has been done yet, in order to evaluate the mental health literacy condition in Iran. The only study has been done regarding the assessment of health literacy in Iran, has not addressed the mental health literacy condition.[20]

WHAT SHOULD WE DO?

There are some evidences that a broad spectrum of interventions can develop the level of community mental health literacy including; society campaigns, educational interventions, mental health education, first aid and also information websites. Improving the level of mental health literacy in society needs to focus on national policies and community monitoring, in a way that all people will be able to improve their mental health.[2122]

Since the mental health services has been provided in Iran such as some other developing countries like China, India and Pakistan,[2324] training the mental health providers about improving the mental health level in society, could be a strategic point for effective interventions in order to prevention and treatment of mental health disorders.[25]

Considering the lack of information about the mental health literacy condition in Iran, it seems vitally important to carry out a comprehensive assessment for achieving some essential information in this field in order to design and make appropriate interventions for improving the level of mental health literacy.