Modifiable predictors of mental health literacy in the educational context: a systematic review and meta-analysis.

Mental health literacy is vital for well-being in educational settings, extending beyond academics to include social and emotional development. It empowers individuals, allowing them to recognize and address their mental health needs and provide essential support to their peers. Despite the acknowledged importance of modifiable factors, there is a noticeable research gap in those amenable to change through educational interventions. Thus, this systematic review aims to identify potentially modifiable predictors of mental health literacy in the educational context. A systematic search was conducted for quantitative studies published between 2019 and October 2023 using several databases following PRISMA guidelines. Studies needed to focus on potentially modifiable predictors of mental health literacy in the educational context. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS tool). In total, 3747 titles and abstracts were screened, 60 articles were assessed in full-text screening, and 21 were included in the review. Significant correlations between mental health literacy and modifiable predictors, including stigma toward professional help, self-efficacy, attitudes toward help-seeking, social support, positive psychological states, receiving mental health training, and psychological distress, were identified. By addressing these factors, educational institutions can cultivate community's adept in mental health, fostering an environment marked by empathy, understanding, and proactive engagement in addressing mental health issues. The implications serve as a foundation for future research, policy development, and implementing of practical strategies to enhance mental health literacy in diverse educational settings.

Effects of the Mental Health Supporter Training Program on mental health-related public stigma among Japanese people: A pretest/posttest study.

Aim: The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants. Methods: The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6-month follow-up (T3). A mixed model for repeated-measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's d. Results: The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [t = 3.20, p = 0.001]; intended behavior [t = 8.04, p < 0.001]). However, when compared at each time point, only intended behavior from T1 to T2 showed a significant difference (t = 8.37, p < 0.001). Significant pooled effects were found for mental health literacy (knowledge: t = 19.85, p < 0.001; attitude: t = 15.02, p < 0.001), knowledge of mental health (t = 28.04, p < 0.001), and psychological distress (t = -2.41, p = 0.016). Conclusion: The results suggest that the program might be effective for improving intended, but not reported, behavior in the short term and for improving mental health literacy, knowledge of mental health, and psychological distress.

Mental health literacy and associated factors among traditional healers of Jimma town, southwest, Ethiopia 2020: a community based, cross-sectional study.

Background: Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia. Method: A community-based cross-sectional study design was employed among 310 participants. To select the participants from Jimma town, a stratified random sampling method was utilized from August 1 to September 30, 2020. The Mental Health Literacy Questionnaire was used to assess mental health literacy for assessment of mental health literacy among traditional healers. The collected data were coded and entered into EpiData version 4.6 and exported to SPSS version 25.0 for analysis. Bivariate and multivariable linear regression was used for data analysis. Result: The finding of this study showed that the samples of traditional healers found in Jimma town scored a total mean of 95.91 ± 3.0025 for mental health literacy. Age [ß = -0.052 (95% CI: -0.078, -0.026)], year of experience [ß = 0.095 (95% CI: 0.067, 0.123)], family history of mental illness [ß = 1.709 (95% CI: 0.543, 2.360)], history of professional help seeking on mental illness [ß = 0.501 (95% CI: 0.715, 2.288)], history of getting information of mental illness on media [ß = 0.941 (95% CI: 0.345, 1.538)], training on mental health [ß = 2.213 (995% CI: 1.520, 2.906)], history of treating mental illness [ß = 1.676 (95% CI: 0.808, 2.544)], and informal education [ß = -1.664 (95% CI: -2.081, -1.247)] were factors significantly associated with MHL. Conclusion: The mental health literacy of traditional healers mean score is lower than the mean score of other studies. Age, year of experience, training on mental illness, family history, history of professional help seeking, history of treating mental illness, information on mental illness, and informal education are significantly associated with mental health literacy. Therefore, structured training is very important to improve their level of mental health literacy.

Psychological resilience and related factors among primary care workers in Wuhan, China: A cross-sectional study.

Purpose: Primary medical workers constitute a high-risk group for mental health problems, and psychological resilience might protect them from the negative psychological impacts of their work. Therefore, this study aimed to investigate the current situation of psychological resilience among primary care workers in Wuhan, China, as well as related factors. Methods: In this cross-sectional study, a total of 417 primary care workers (30.0 % men; 38.5 ± 8.5 years old) were randomly selected to complete a questionnaire. The brief version of the National Mental Health Literacy Questionnaire and the Psychological Resilience Scale were used to assess participants' mental health literacy and psychological resilience, respectively. Multiple linear regression was performed to identify factors associated with the psychological resilience of primary care workers. Results: More than four-fifths of the primary care workers included in this study exhibited appropriate levels of mental health knowledge. In terms of mental health skills, participants' attainment rates, ranging from high to low, were 60.9 % for distracting attention, 45.3 % for interpersonal support and 43.9 % for cognitive reappraisal. The average psychological resilience score obtained by primary care workers was 27.81 ± 5.71, and the factors associated with increased psychological resilience included being male, being older, and possessing higher mental health skills, including skills pertaining to interpersonal support and distracting attention. Conclusion: The psychological resilience of primary care workers in Wuhan is at a moderate level and thus requires further improvement. Although these medical staff exhibit appropriate levels of mental health knowledge, their mental health skills are relatively poor, despite the fact that interpersonal support and distracting attention are significantly associated with psychological resilience. Hence, interventions targeting mental health skills are recommended to promote psychological resilience among primary care workers.

Mental health literacy and academic performance (MHLAP) in high school students: a randomized clinical trial protocol.

BACKGROUND: Mental health literacy is a promising avenue of intervention for addressing the development of psychopathology, as well as its associated consequences, such as a decrease in academic performance. The current study aims to test the effectiveness of such an intervention in high school students, focusing on two main formats of delivery: (1) automated and (2) blended. METHODS: To achieve this aim, a randomized clinical trial with direct comparisons at three time points between three conditions (automated, blended, and waitlist) was designed. Power analyses yielded a necessary sample size of 264 high school students. The participants will be selected from Romanian high schools. DISCUSSION: The current study aims to contribute to the mental health literacy literature by testing the effectiveness of an educational intervention concerning mental health in terms of its benefits for reducing psychopathology and increasing academic performance. The success of such an intervention bears important implications for addressing mental health in the educational system. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT06217744, version 1, 22 January 2024.

Effectiveness of a mental health literacy module on stigma related mental health knowledge and behaviour among youth in two educational settings in Chennai, South India: A quasi-experimental study.

BACKGROUND: Improving mental health literacy (MHL) can reduce stigma towards mental illness, decreasing delays in help-seeking for mental disorders such as psychosis. We aimed to develop and assess the impact of an interactive MHL intervention on stigma related mental health knowledge and behaviour (SRMHKB) among youth in two urban colleges in South India. METHODS: Incorporating input from stakeholders (students, teachers, and mental health professionals), we developed a mental health literacy module to address SRMHKB. The module was delivered as an interactive session lasting 90 min. We recruited 600 (300 males; 300 females; mean age 19.6) participants from two city colleges in Chennai from Jan-Dec 2019 to test the MHL module. We assessed SRMHKB before the delivery of the MHL intervention, immediately after, and at 3 and 6 months after the intervention using the Mental Health Knowledge Schedule (MAKS) and Reported and Intended Behaviour Scale (RIBS). We used generalised estimating equations (GEE) to assess the impact of the intervention over time. RESULTS: Compared to baseline, there was a statistically significant increase in stigma related knowledge and behaviour immediately after the intervention (coefficient=3.8; 95% CI: 3.5,4.1) and during the 3-month (coefficient=3.4; 95% CI: 3.0,3.7) and 6-month (coefficient=2.4; 95% CI: 2.0,2.7) follow-up. CONCLUSION: Preliminary findings suggest that a single 90-minute MHL interactive session could lead to improvements in SRMHKB among youth in India. Future research might utilise randomised controlled trials to corroborate findings, and explore how improvements can be sustained over the longer-term.

An exploratory analysis of moderating effects in a non-randomized, quasi-experimental evaluation of a college-based mental health literacy curriculum.

Objective: To assess possible moderating variables that influence the effectiveness of a college-based mental health literacy curriculum, Mental Health Awareness and Advocacy (MHAA). Participants: Students at a Western University in the United States (MHAA treatment group: N = 474; Comparison group: N = 575). Methods: Using a non-randomized, quasi-experimental design over six semesters (2017-2019), students in the treatment and control groups reported on key demographic factors, experiences with mental health, and their knowledge, self-efficacy, and behaviors related to mental health literacy in a pretest/post-test format. Linear mixed effects models were used to assess moderation. Results: MHAA curriculum's efficacy varied based on participants' current depression and anxiety levels, whether they had prior personal experience with a mental health concern, whether they had been diagnosed with a mental health concern, and whether they had experienced suicidal thoughts. Conclusions: Reducing anxiety and depression among students may increase the efficacy of the MHAA program.

Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland.

This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.

The relationship between mental health literacy and professional psychological help-seeking behavior among Chinese college students: mediating roles of perceived social support and psychological help-seeking stigma.

Introduction: Mental health literacy is viewed as a significant factor that may facilitate an individual's pursuit of professional psychological assistance. However, it is important to explore further influencing factors that might underlie this association. This study, employing the framework of the Theory of Planned Behavior (TPB), aims to examine the relationship between mental health literacy and the behavior of seeking professional psychological help, with a focus on the potential mediating roles of perceived stigma and social support in this context. Methods: We surveyed 911 college students in seven regions of China (406 males and 505 females, aged between 19 and 25 years old; M age = 19.65, SD = 1.41) utilizing self-report measures, including the Mental Health Literacy Questionnaire, Professional Psychological Help-Seeking Behavior Scale, Professional Psychological Help-Seeking Stigma Scale, and Perceived Social Support Scale. A chain mediation model was developed to analyze the interconnections between mental health literacy, stigma related to seeking psychological help, perceived social support, and professional psychological help-seeking behaviors. Results: The mediation effect analysis indicates that: (1) mental health literacy significantly positively correlates with professional psychological help-seeking behaviors; (2) both perceived social support and professional psychological help-seeking stigma significantly mediate the relationship between mental health literacy and professional psychological help-seeking behavior; (3) perceived social support and the stigma associated with seeking professional psychological help play a chained mediating effect between mental health literacy and the behavior of seeking professional psychological help. Discussion: This study found that mental health literacy indirectly facilitates professional psychological help-seeking behaviors by enhancing the perception of social support and reducing the stigma associated with seeking such help. These findings help in understanding how improving mental health literacy and perceived social support while reducing stigma can increase the likelihood of individuals seeking professional psychological assistance. The results are significant for enhancing the utilization of mental health services and implementing mental health education programs in universities.

Visitor characteristics and changes in mental health stigma after attending the Mind Space mental health experience exhibition.

Introduction: Mind Space is an experiential mental health exhibition in Hong Kong, aiming to raise public awareness and provide education regarding mental health. This prepost study aimed to 1) examine the relationships between visitors' characteristics and their mental health stigma at baseline, and 2) provide a preliminary evaluation of the effectiveness of Mind Space in reducing stigma and promoting help-seeking attitudes toward mental health conditions. Methods: We analyzed data from all consenting visitors who attended Mind Space between September 2019 and December 2021. Visitors' attitudes toward mental health conditions and their willingness to seek professional psychological help were measured through online questionnaires before and after visits. Multiple linear regression was used to identify the demographic predictors of outcome variables at baseline. Changes in outcome variables after attending Mind Space were assessed using paired sample t-tests. Results: A total of 382 visitors completed the baseline questionnaires, among which 146 also completed the post-test. At baseline, higher socioeconomic levels and personal contact with people with mental health conditions predicted more positive attitudes and understanding toward mental disorders. Tentatively, the results also showed that after attending Mind Space, a significant reduction in negative attitudes about mental illness (t=4.36, p=<.001; d=.361) and improvements in the propensity to seek professional help (t=-5.20, p<.001; d=-.430) were observed, along with decreases in negative attitudes toward stereotypes (t=4.71, p=<.001; d=.421) and restrictions (t=2.29, p=.024; d=.205) among healthcare professionals. Discussion: Our findings highlight the need for mental health education for people with lower socioeconomic status and the importance of direct contact in public mental health education initiatives. The present study also suggests that Mind Space may be a useful model for public mental health education, but the exhibition requires further evaluation to ascertain if any reductions in stigma are maintained over time.

The predictors of mental health literacy among adolescents students.

AIM: This study aimed to examine levels of mental health literacy (MHL) and associated factors among adolescents. METHODS: A descriptive, cross-sectional, analytical study was conducted with a total of 650 students aged 11-18 years in three middle and three high schools. Data were collected using the Child and Adolescent Mental Health Literacy Scale and evaluated using descriptive statistics and regression analysis to determine whether age, gender, and grade are predictive factors of MHL. RESULTS: The mean age of the participants in the study was 16.8 ± 1.35 years, 55 % of the students were girls, and the mean MHL score was 3.96 ± 1.2, indicating moderate MHL. Multiple regression analysis indicated that the variables of age, gender, and grade explained 5.5 % of the variance in MHL score. When these variables were examined individually, gender and grade had no significant effect (p > 0.05), while older age was associated with higher MHL score (p < 0.05). CONCLUSION: The results of this study showed that MHL improved with age. MHL promotion is important in mental health resilience. Collaboration between school nurses, school counselors, and psychiatric nurses to provide mental health educational interventions may help reduce stigma and increase help-seeking behaviors.

A Universal Program to Improve Mental Health among Youth from Low-Income Predominantly Minority Communities: Implementation of Advocates 4 ALL Youth (ALLY).

Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs). The feasibility of delivering ALLY in a racially and minoritized low-income community is discussed and modifications required to implement the program documented. Students completed questionnaires and sessions with an ALLY. Aspects of program delivery deemed feasible included training ALLYs to delivery program, stakeholder buy-in regarding missing class time, and students attending the sessions. Further modifications included adjustments to materials due to lower reading level and health literacy related-educational needs. Programs designed in one demographic setting may not work in a different setting.

Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study.

Introduction: Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach. Methods: Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis. Results: Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours. Conclusion: Support for Chinese elite athletes' mental health and help-seeking requires improvement.

An exploratory cross-sectional study on Mental health literacy of Spanish adolescents.

BACKGROUND: Mental health literacy (MHL) is especially important for young people, but comprehensive studies on MHL in adolescents are limited, with no nationwide studies in Spain. This research aims to study MHL among Spanish adolescents and its relationship with sociodemographic factors. METHODS: An exploratory study is carried out using stratified random sampling in Spanish adolescents (N = 1000), aged 12-16 years and balanced in terms of gender, age and territorial distribution. Data collection took place in October and November 2023 through online surveys using the CAWI methodology. Sociodemographic variables, contact with mental health and the Spanish version of the Mental Health Literacy Questionnaire (MHLq-E), a self-administered instrument of 32 Likert-type items (1-5) that assesses the dimensions of help-seeking skills, knowledge about causes and symptoms, and stigma, were evaluated. Descriptive and multivariate analyses of variance (MANOVA) were conducted. RESULTS: In general, adequate levels of literacy were observed, although some aspects related to help-seeking towards teachers, stigmatising attitudes towards people of low economic status and knowledge of severe mental health problems could be improved. The results show contact with previous mental health problems as a key variable for stigma and knowledge about symptomatology together with age. Likewise, gender and family educational level were found to be related to the ability to seek professional help. CONCLUSION: This study provides information on levels of MHL among Spanish adolescents and highlights significant socio-demographic variables. These findings pave the way for interventions aimed at improving adolescents' understanding, attitudes and skills to manage mental health problems, making possible to adapt content and focus on specific groups, thus increasing its effectiveness.

Adolescent boys' experiences of mental health and school health services - an interview study from Norway.

BACKGROUND: Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys' experiences of mental health and school health service. METHODS: An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study. RESULTS: The overall theme "barriers towards seeking help", and three categories- navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking-described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness. CONCLUSIONS: Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

'There's no waiting list, just press play': listeners' experiences of mental-health-related podcasts.

INTRODUCTION: The activity of podcasting has increased exponentially but little is known about the qualitative listener experiences of podcasts related to mental health. The aim of this study was to understand what listeners of mental health podcasts obtain from this medium. Participants were asked questions relating to mental health literacy, stigma and help-seeking behaviour. METHODS: The study gathered data, via an online survey (n=722). This article reports on the responses to open-ended questions: 'What do you take away from listening to mental health-related podcasts? What do you learn about yourself (or a loved one)? What do you find most useful about listening to mental health-related podcasts?' Inductive thematic analysis was utilised. RESULTS: Thematic analysis produced five core themes: accessibility, mental health literacy, potential pitfalls, reassurance and lived experiences. Accessibility of material and discussions featuring professionals and people with lived experience were reported key highlights. CONCLUSION: Results indicate that podcasts influence the development of mental health literacy, reduce stigma and increase help-seeking. Given the challenges with service access in underserved populations, there is a potential role for the use of podcasts in rural regions.

An international interdisciplinary approach to developing video educational materials promoting mental health literacy among adolescents in the Philippines.

AIM: Adolescent mental ill-health is a common international challenge affecting both high- and lower-middle-income countries. The Republic of the Philippines enacted its first mental health law in 2019, underlining the importance of the promotion of adolescent mental health education in schools. In Japan, course instructions about mental ill-health were formulated in a Course of Study that reflects governmental curriculum guidelines. Embedded since 2022, the Course of Study aimed to promote an understanding of current issues of adolescent health. The National Center for Global Health and Medicine in Japan has been sharing experience of promoting public health practices and advancing medical technology in low- and middle-income countries, especially in the Western Pacific region. This paper describes the development process and content of these resources by an interdisciplinary team from Japan and the Philippines. METHODS: The interdisciplinary team created an embedded mental health education programme using animated videos for the Philippine school curriculum to improve mental health literacy in adolescents. RESULTS: Two six-minute animated videos of age-relevant stories were created. The animation scenarios illustrate: 1) mental health problems and recovery; and 2) major symptoms of mental illnesses, including depression, anxiety, and schizophrenia. Each animated video presents several items for discussion among students and/or teachers, both in class and online for students unable to attend school. CONCLUSION: Our efforts may provide good opportunities for enhancing adolescents' mental health activities in the Philippines. In the following steps, we should investigate the effectiveness of school-based MHL using these animated videos with rigorous evaluation methods.

Improving mental health literacy using web- or app-based interventions: A scoping review.

Background: Given the rapid advancement in technology, the Internet has grown to play a significant role in the field of healthcare. Individuals can now access a profusion of easily available materials for self-management of their health. The purpose of this review is to describe Web/App-based interventions that are primarily or secondarily designed to improve mental health literacy (MHL) and to investigate the effectiveness of online interventions for improving mental health. Materials and Method: A scoping review was conducted by searching five databases: PsycINFO, EMBASE, PubMed, CINAHL, and Web of Science. The search was limited to peer-reviewed journals published in English between 2000 and 2022. Studies focusing on enhancements of MHL or its constituent components were included. Results: Twenty-four studies met the inclusion criteria. The interventions primarily targeted patients or individuals exhibiting symptoms of mental disorders, with a higher representation of female participants. All the interventions yielded positive outcomes. The included studies were categorized according to three themes: knowledge, attitude, and self-care skills. Although numerous studies have focused on knowledge improvement, research on interventions targeting self-care skills is scarce. Furthermore, existing literature on knowledge enhancement is limited in terms of the coverage of risk factors. Conclusion: This review indicates gaps in web/app interventions including limited evidence on risk factors, inconsistent help-seeking awareness, and inadequate self-care skills training. Further research is critically needed to address these deficiencies and promote comprehensive MHL.

Originalarbeiten / Original Articles. Entwicklung und Evaluation einer Aufklärungsbroschüre zu Ängsten und Angststörungen für Jugendliche.

Development and Evaluation of an Information Brochure on Anxiety and Anxiety Disorders for Adolescents Low mental health literacy and fear of being stigmatized are two main barriers that detain adolescents fromseeking professional help. An information brochure about anxiety disorders for adolescents was developed. To make a first statement about the quality of the brochure, 19 experts, consisting of (child and adolescents) psychotherapists, psychiatrists, and psychologists, rated a first version of the brochure regarding content validity and age-appropriatness. To evaluate the efficacy in knowledge and the acceptance of the brochure, a revised version was evaluated by N = 174 adolscents (106 female-, 66 male- and two non-binary) between 14 and 17 years of age (M = 16.56 years.; SD = 0.57).The experts' approval of all content items totals a mean average of 95.2 % (range: 84.2-100 %). In the adolescent sample, the intervention increased knowledge about anxiety disorders (d = 1.04) and improved attitudes about coping strategies (d = 0.99). Results of the experts' rating showed that content validity of the brochure can be assumed.The revised brochure seems to be a useful and effective tool to inform adolescents about anxiety disorders.

The revision and factor analytic evaluation of the German version of the depression literacy scale (D-Lit-R German).

BACKGROUND: Depression is a common mental health disorder and the second leading cause of disability worldwide. In people with depression, low depression literacy, which could be characterized by a poor recognition of depressive symptoms and less knowledge about the availability of treatment options, can hinder adequate therapy for depression. Nevertheless, questionnaires measuring depression literacy in Germany are rare. Consequently, for the present study, the German Depression Literacy Scale (D-Lit) has been revised and evaluated. METHODS: First, a team of clinical psychologists revised the D-Lit German scale. Next, cognitive interviews were conducted with patients with depression to improve the comprehensibility of the scale items. Our revision of the D-Lit-R German scale was then subjected to an anonymous online study. Finally, the data went through an exploratory factor analysis, and sociodemographic subgroup analyses were performed. RESULTS: N = 524 individuals (age 18-80) completed the D-Lit-R German scale and a questionnaire on their sociodemographic data. Cronbach´s alpha was estimated as α = .72, and McDonald's Omega (categorical) was estimated as ω = .77. The mean Item difficulty was M = .75 (SD = .15). An EFA was performed for a unidimensional model, a 5-factor-model and at last a 3-factor-model. The 5-factorial model showed a good model fit (χ2emp,WLSMV(131) = 92.424, p > .05; CFI = 1, RMSEA = 0, SRMR = .07) but was rejected since the content of the potential 5 factors could not be determined. The 3-factor model showed an arguable model fit. The Chi2 test was significant (χ2emp,WLSMV(168) = 199.912, p < .05), but the CFI and the RMSEA met an acceptable model fit (CFI = .990, RMSEA of .019, 90% CI[.003, .029]). Substantively, the three factors were defined as (1) Distractors and other symptoms, (2) Depressive symptoms, and (3) Pharmacological and psychotherapeutic depression treatment. Furthermore, there were significant differences in sum scores regarding the subgroup's gender, treatment for mental health problems, depression treatment, experience with depression, and different career fields. CONCLUSIONS: The D-Lit-R German scale is a time-efficient scale to assess some aspects of the depression literacy construct that can be easily applied. Since there was no perfect model fit, it is recommended to continue to revise the scale. Further evaluation studies could ask for knowledge of the etiological factors of depression. Future studies could then use this instrument to convey depression literacy. This instrument could assess the growth of knowledge after psychoeducational interventions in different settings. TRIAL REGISTRATION: This trial was preregistered at the platform osf.io ( https://osf.io/49xdh ). REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/49XDH Date of registration: 28 April 2022.