Parental Child Mental Health Literacy: Current state of research and the development of a new measure

Abstract

Health literacy, and to a lesser extent, mental health literacy, have been useful constructs for highlighting how personal characteristics can influence health outcomes and inequities in access to information and resources. However, this concept has generally not been extended to the mental health of young children. This thesis aimed to explore parental understanding of, and attitudes towards, child mental health difficulties and help-seeking, that is, the construct of parental child mental health literacy. The thesis consists of three papers. Paper one provides a systematic review of the literature of child mental health literacy of parents of young children (aged 4 to 12 years old) in non-clinical populations. Twenty-six studies were included across twelve countries. Overall levels of child mental health literacy across knowledge, attitudes and help-seeking domains were synthesised. Parental factors influencing child mental health literacy were also identified. While there was substantial variation in findings across populations and disorders, some evidence for the influence of child mental health literacy on help-seeking emerged. The review highlighted heterogeneity in study design and measurement of child mental health literacy. Considering these findings, recommendations are made to improve the methodological quality of future research and parental child mental health literacy through intervention and health policy. Clinical implications for professionals working with children and parents are also discussed. Paper two developed and provided preliminary validation of a new measure, the Parental Child Mental Health Literacy Questionnaire (PCMHLQ). The PCMHLQ was systematically developed over three stages including defining the concept of child mental health literacy, generation of an item pool through literature searches, consultation with experts and piloting with parents. A total of 211 parents recruited through schools and social media completed the PCMHLQ online, along with measures of adult mental health literacy, health literacy, child emotional and behavioural difficulties and parental mental health. Principal components analysis revealed a five-factor structure of the PCMHLQ, including knowledge, recognition, attitudes, stigma, and help-seeking confidence. Overall, the PCMHLQ demonstrated good reliability and convergent validity with adult mental health literacy. The PCMHLQ demonstrated preliminary utility in discriminating parents expected to vary in their child mental health literacy. Future research is required to improve the reliability of sub-scales, specifically knowledge and recognition, and to test the factor structure in a larger, more representative sample. Paper three provides a critical evaluation of papers one and two. Reflections are offered on the study design, decision making and implementation of the research process. The strengths and limitations of the research are appraised, and the clinical and research implications discussed.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Ming Wan (Supervisor) & Katherine Berry (Supervisor)