The Role of Mental Health Literacy on Confidence in Helping Someone with Mental Health Problems Among Public Housing Staff

Background and Purpose: Public housing is an important resource for those with lower incomes, disabilities, and the elderly—all of whom are at a greater risk for mental health problems. Compared to non-public housing residents, public housing residents reportedly have poorer mental health. Despite high needs for mental health care, many public housing residents remain untreated. Untreated mental health problems in public housing might result in evictions, homelessness, suicide, or homicide. Early detection and intervention can help improve public housing residents’ mental health and thereby promote the length and quality of lives. The capacity of recognizing residents with mental health problems and referring those residents to adequate mental health services in a timely manner seems critical for public housing staff members that are likely to have frequent contact with residents. Yet, little is known about their understanding of mental health and helping residents with mental health problems. To bridge these knowledge gaps, this research examined relationships among mental health literacy (MHL), perceived familiarity with mental illness (perceived familiarity), social distance from a person with mental illness (social distance), and confidence in helping someone with mental health problems (confidence) among public housing staff.

Methods: This study used the data from a cross-sectional survey that examined the MHL of a local public housing staff in Texas. The survey questionnaire included a 30 item MHL measure; a social distance scale; one item measuring perceived familiarity; four items measuring confidence; and demographics. Exploratory and confirmatory factor analyses of all measurement models indicated good model fits. One hundred ninety four completed surveys were used for data analysis. Structural Equation Modeling (SEM) was conducted to examine the way in which MHL influences confidence along with testing potential mediation effects of perceived familiarity and social distance.

Results: The results of SEM (c²  (552, N = 194) = 639.67, p = <.01; RMSEA = .03 (.02 - .04); CFI = .95; and TLI = .95) suggested that the relationship between MHL and confidence was partially mediated by perceived familiarity. MHL was marginally significant yet positively related to confidence (b = .31, p= .055) and perceived familiarity (b = .72, p=< .001), and negatively associated with social distance (b =.54, p= < .001). Hypothesized mediation effects were only demonstrated with perceived familiarity. Perceived familiarity was positively associated with confidence (b = .34, p= < .01). Social distance had no statistically significant relationship with confidence (b = .06, p= .48).

Conclusions and Implications: The findings suggest that MHL has an important role on confidence in helping someone with mental health problems among public housing staff. Higher MHL was directly associated with greater confidence but also influenced the way in which a person feels more familiar with mental illness, which in turn increased confidence. Findings highlight the importance of mental health education for public housing staff to improve their confidence in helping public housing residents with mental health problems. This study also urges social workers to consider active involvement of mental health education in community settings.