Mental Health Literacy Among Older Adults: A Cross-Sectional Study

Mental Health Literacy Among Older Adults: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mental Health Literacy Among Older Adults: A Cross-Sectional Study Elif SARAÇ, Remziye CAN, Esra YILDIZ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6554323/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Jul, 2025 Read the published version in Discover Public Health → Version 1 posted 9 You are reading this latest preprint version Abstract Objective Mental health literacy refers to people's knowledge and beliefs about mental disorders, their ability to recognize them, and their knowledge of help-seeking decisions. There is a lack of knowledge regarding health literacy in older adults in Turkiye. Aim The aim of current study is to measure the level of mental health literacy of older individuals and to create new grounds about the topic. Methods For this cross-sectional study, 163 cognitively healthy people aged ≥ 65 were included. Demographic characteristics form and “Mental Health Literacy Scale-TR" were used to collect data. Age, marital status, and education were identified as associated with mental health literacy. Results The mean age of participants was 70.71 ± 4.35. 41.7% of them were male and 8.6% of them had Bachelor's Degree. The mean score of Mental Health Literacy Scale-TR was 12.42 ± 3.68. Conclusion Mental health literacy level of older adults was moderate.The findings underscore the ongoing need for communities to support the development of mental health literacy skills among elderly individuals.Additionally, present study emphasizes the importance of further investigating mental health help-seeking behaviors, and the stigma surrounding mental health. Mental Health Literacy Elderly 1. Introduction Mental health literacy is a critical component in promoting mental health among older adults [ 1 ]. In addition to health literacy, individuals need general health knowledge to actively participate and make informed choices about their health [ 2 ]. Recently, the demand for mental health services and their utilization has significantly increased. This trend encourages individuals to seek psychological help for emotional, mental, and social problems experienced not only by themselves but also by their families [ 2 ]. Consequently, the importance of mental health literacy for older adults has grown even more. Mental health literacy (MHL) refers to people's knowledge and beliefs about mental disorders, their ability to recognize these disorders, and their understanding of help-seeking decisions [ 3 ]. This concept includes promoting mental health awareness and creating a supportive environment for people with mental disorders to facilitate early intervention. Improving MHL helps reduce stigma and discrimination and guides appropriate help-seeking behavior for those in need. Due to generally poor mental health literacy, mental disorders are often poorly recognized, leading to delays in treatment [ 4 ]. Many studies have examined the MHL of community-dwelling people or clinical patients but have paid little attention to the MHL of older adults [ 5 ]. The lack of data on this issue necessitates a deeper understanding of MHL in older individuals [ 5 ]. Understanding the MHL of older adults is crucial for informing and improving mental health interventions and applications. By identifying gaps and strengths, targeted and effective training and applications can be developed. Previous studies have primarily focused on the MHL of depression and anxiety, rarely investigating the MHL of other mental disorders, such as psychosis and dementia [ 6 , 7 ]. Consequently, the MHL levels of the older adults regarding these other disorders are not well known. It is valuable and important to investigate whether older adults fully recognize and understand various mental disorders and whether they have positive attitudes and intentions toward helping those suffering from these disorders. Additionally, older adults, who now constitute the largest segment of society due to the increasing older population, may face involuntary hardships caused by decreasing income and rising health expenditures [ 8 ]. However, mental health problems and the associated costs can be minimized by improving individuals' ability to recognize mental health issues and access necessary health services. Globally, the terms "Health Literacy" and "Mental Health Literacy" are used to emphasize the importance of understanding and processing health-related information to maintain one's health and effectively utilize health services [ 9 , 10 ]. Individuals who can read, interpret, understand, and apply healthcare information are better equipped to manage their health problems, require fewer health-related limitations, and experience lower degrees of disability compared to those without health literacy skills [ 11 ]. This study has focused on assessing the level of mental health literacy among older individuals. Their understanding of mental health was measured, contributing new insights on the topic. This study is the first of its kind in our country, specifically targeting individuals aged 65 and over to determine their mental health literacy. 2. Materials and Methods 2.1.Type, Population and Sample of the Study This observational cross-sectional study aimed to explore the mental health literacy of older adults. It was conducted in June 2024, involving 163 voluntary participants aged 65 and above in Erzurum, a city in eastern Turkiye. No specific sampling method was employed; the study aimed to include all individuals aged 65 and above who sought healthcare services at the hospital. The hospital serves as a regional center, catering to patients from the surrounding provinces of Kars, Agrı, Mus, Artvin, Bayburt, Erzincan, Gumuşhane, and Igdır, across all medical specialties. 2.2.Data Collection 2.2.1.Demographic Characteristics Form The form included information on age, sex, marital status, and education level. 2.2.2.Mental Health Literacy Scale-22-TR The Mental Health Literacy Scale-22-TR was originally developed by O’Connor and Casey (2015) and adapted into Turkish by Goktas et al. (2019)[ 12 ]. The scale provides to measure the mental health literacy levels of people in community and consists of 22 items divided into three sub-groups: knowledge-based literacy, belief-based literacy, and resource-oriented literacy. The internal consistency coefficient of the original scale, as adapted by Goktas, was 0.71. Most items are affirmative statements, except for the belief-based literacy sub-dimension (items 11–18). It is a six-point Likert scale ranging from 1 to 0 up to item 19. “Certainly agree” and “Agree” responses are scored as 1, while “Certainly disagree,” “Disagree,” and “Don't know” are scored as 0. Items 19 to 22 (resource-oriented literacy) are scored with “Yes” responses as 1 and “No” responses as 0. The total possible score on the scale ranges from 0 to 22. The Mental Health Literacy (MHL) scores and sub-dimensions are presented in Table 1. Table-1 Mental Health Literacy Scale and Sub-Dimensions S. N. MHLS-TR Sub-dimensions Items Numbers 1 Knowledge Based Literacy 1–10 2 Belief Based Literacy 11–18 3 Resource Oriented Literacy 19–22 2.3.Data Analyses Data were evaluated using the SPSS (Statistics Program for Social Sciences) Windows Version 20.00 software package. The Kolmogorov-Smirnov (KS) test indicated that the data were normally distributed (p = 0.000). Analyses included Cronbach's Alpha reliability test, Kolmogorov-Smirnov normality test, independent t-test, one-way ANOVA, and Pearson correlation analysis. Additionally, Games-Howell post-hoc analysis was conducted to determine the specific differences between effective factors. The mean scores of the scale and its sub-dimensions were calculated. 2.4.Ethics Informed consent was obtained from older adults who participated in the study after providing them with relevant information. Participants were informed that the confidentiality of their personal information would be protected, that they would not be held liable for any financial loss, and that they could withdraw from the study without giving any reason during the study. Ethical approval was obtained from the Clinical Research Ethics Committee of Ataturk University hospital medical school (date 7/6/24, approval number: 15). This study is reported in compliance with the Declaration of Helsinki. Additionally, permission to use the scale was obtained from Goktas et al. 3. Results 3.1. Demographic Characteristics of Respondents The study population comprised 41.7% women and 58.3% men, with an average age of 70.71 ± 4.35 years. The majority, 79.8%, were married, and 8.6% held a Bachelor's Degree. Detailed demographic characteristics are presented in Table 2 . Table-2. Demographic Characteristics of the Respondents Age mean ± sd 65 and above 70.71 ± 4.35 n % Sex Female 68 41.7 Male 95 58.3 Marital Status Married 130 79.8 Single 33 20.2 Education Literate 69 42.3 Primary School 45 27.6 Secondary School 35 21.5 Bachelor’s Degree 14 8.6 Total 163 100 Ort ± ss Min Max The mean score of Knowledge Based literacy 5.42 ± 2.51 .00 10.00 The mean score of Belief Based Literacy 4.35 ± 2.52 .00 15.00 The mean score of Resource Oriented L. 2.65 ± 1.43 .00 4.00 The mean score of MHLS 12.42 ± 3.68 1.00 21.00 3.2.Analyses of MHLS-TR The highest score was observed in "Knowledge-Based Literacy" (5.42 ± 2.51), while the lowest was in "Resource-Oriented Literacy" (2.65 ± 1.43). The total score for the MHLS-TR was 12.42 ± 3.68, with an internal consistency coefficient of 0.639 for the 22 items. Overall, older adults demonstrated a moderate level of MHL. 3.3.Comparative Analysis of MHLS-TR Scores Across Demographic Characteristics Statistically significant findings from our study include a negative correlation between "Knowledge-Based Literacy" and age (p < 0.05), and a significant difference in "Knowledge-Based Literacy" based on marital status (p 0.05). However, a significant difference was found between education level and MHLS-TR scores (p < 0.05). Due to unequal variances, Games-Howell post-hoc analysis was conducted, revealing that individuals with a Bachelor’s degree had higher scores. Detailed results are presented in Table 3 . Table-3. Comparative Analysis of MHLS-TR Scores Across Demographic Characteristics Effective Factor Total MHL-TR ort ± ss Knowledge Based Literacy ort ± ss Belief Based Literacy ort ± ss Resource Oriented Literacy ort ± ss Age r p -0.142 0.070 -0.229 0.003* 0.084 0.285 -0.110 0.161 Sex Female Male 12.30 ± 3.90 12.51 ± 3.53 5.27 ± 2.42 5.52 ± 2.58 4.17 ± 2.49 4.48 ± 2.55 2.85 ± 1.36 2.50 ± 1.47 t p -0.353 0.725 -0.617 0.538 -0.765 0.445 1.528 0.128 Marital Status Married Single 12.63 ± 3.66 11.60 ± 3.69 5.61 ± 2.50 4.66 ± 2.47 4.31 ± 2.58 4.51 ± 2.33 2.70 ± 1.42 2.42 ± 1.47 t p 1.443 0.151 1.951 0.050* -0.404 0.687 1.011 0.313 Education Literate Primary School Secondary School Bachelor’sDegree 11.57 ± 4.01 11.93 ± 3.20 13.54 ± 3.22 15.42 ± 2.24 4.91 ± 2.24 5.13 ± 2.39 5.82 ± 2.86 7.85 ± 1.74 4.01 ± 3.07 4.64 ± 2.17 4.94 ± 1.92 3.64 ± 1.44 2.65 ± 1.41 2.15 ± 0.36 2.77 ± 1.55 3.92 ± 0.26 F p 6.207 0.001* 6.394 0.000* 1.634 0.184 6.065 0.001* r: Correlation Analyses, F: One Way Anova Test, and Games Howel Post-hoc Analysis, t: Independent t test, *p < .05 statistical significance. Furthermore, our study found significant positive correlations (p < 0.01, 2-tailed) between the total MHLS-TR score and its sub-scales, indicating a consistent relationship across all dimensions of mental health literacy. Detailed findings are provided in Table 4. Table-4. Correlations Between Total Mental Health Literacy Scale and The Sub-scales Total_MHL KBL BBL ROL Total_MHL Pearson Correlation 1 - - - Sig. (2-tailed) - - - KBL Pearson Correlation .742 ** - - - Sig. (2-tailed) .000 - - - BBL Pearson Correlation .528 ** − .050 - - Sig. (2-tailed) .000 .526 - - ROL Pearson Correlation .334 ** .237 ** − .319 ** 1 Sig. (2-tailed) .000 .002 .000 - N 163 163 163 163 **. Correlation is significant at the 0.01 level (2-tailed). 4. Discussion This paper proposes to assess levels of MHL among older adults living in the community. The assessment aims to evaluate current MHL levels and to improve them where necessary. Importantly, these assessments are designed to be applicable across all cultural groups, acknowledging that older individuals have diverse relationships with mental health. While some may have a high level of MHL, characterized by accessibility, support, independence, experience, and confidence, many others do not share this experience. The study findings revealed that older adults generally exhibited a moderate level of MHL. Globally, empirical evidence suggests that MHL and attitudes towards mental health among the general population remain poor [ 13 – 15 ]. Despite ongoing efforts to improve these levels, there remains a pressing need to assess and enhance MHL specifically within the growing older population in communities. The study also found a significant and positive correlation between the total MHLS-TR score and its sub-scales. Consistent with previous research [ 12 , 16 ]. increases in the total literacy score were mirrored by increases in knowledge, belief, and resource-oriented literacy levels. This finding underscores the expected relationship where higher overall literacy scores correspond to higher levels of specific literacy components in knowledge, belief, and resource access. In the present study, age was identified as a significant factor affecting "Knowledge-Based Literacy" among older adults, with MHL decreasing as age increases. This suggests that older individuals have limited information about mental health. This finding aligns with previous research indicating an inverse association between age and mental health literacy [ 17 – 20 ]. Interestingly, the study found no association between sex and MHL. This contrasts with some evidence suggesting that females generally have higher levels of knowledge and literacy compared to males [ 21 – 23 ]. Conversely, other recent research has suggested that females may have lower MHL [ 24 ]. These discrepancies may be influenced by cultural factors and the average age of study participants. Indeed, similar findings to our study have been reported in the literature [ 25 ]. In our study, marital status was found to significantly influence MHL, with married individuals demonstrating higher levels compared to singles. This contrasts with recent findings suggesting that marital status is not a significant demographic characteristic affecting MHL [ 26 , 27 ]. The higher MHL among married individuals in our study may be explained by the cultural context where marriage often entails broader responsibilities and greater exposure to various topics, including mental health. Moreover, our study highlighted the significant impact of education on MHL levels, with university graduates showing notably higher MHL scores. This finding aligns with previous research indicating that lower levels of education are associated with poorer MHL [ 24 – 28 ]. These findings underscore the importance of identifying and supporting groups that may require additional assistance in improving their mental health literacy. 4.1.Limitations Despite its strengths, the study had a number of limitations. The study participants were restricted to one university hospital in the east of Turkiye, which may limit the generalizability of the findings. The level of mental health literacy of the older adults ones was measured using their self-reporting, not their actual knowledge, skills, or behaviors. Therefore, the actual level of mental health literacy may be lower due to over-reporting because of the tendency for them to describe only their desirable attributes. In addition, in the questionnaire we could not ask so many questions related to demographic characteristics because of the sensitivity of the participants. 5. Conclusions and Recommendations This study assesses the level of mental health literacy (MHL) among older adults, finding a moderate level among participants. Factors such as age, marital status, and education were identified as associated with MHL. The study emphasizes the importance of further investigating mental health help-seeking behaviors, MHL, and the stigma surrounding mental health. This exploration is crucial for effectively identifying older people with low MHL who would benefit from additional education or support. The findings underscore the ongoing need for communities to support the development of mental health literacy skills among older adults. By tailoring interventions based on age, gender, and place of residence, and by developing appropriate policies, both individual and societal MHL can be enhanced. This approach can empower individuals to better manage their own and their family members' mental health effectively. Declarations Author Contribution Conceptualization: ES, RC,EY, Data curation; ES, RC,EY; Formal analysis: ES,EY; Methodology:ES, RC,EY; Resources:ES, RC,EY; Supervision:EY,EY; Visualization: ES, RC,EYWriting - original draft: ES; Review & editing:ES, RC,EY. Acknowledgement We thank to all participants and the manager of the hospital conducted in and to Goktas et al. who formed the MHLS in Turkish. Also we thank to the protranslate editing service for editing manuscript. Data availability statements The datasets generated during and/or analysed during the current study are not publicly available due [The confidentiality of the data used, the sensitive nature of the questions asked in the research, and the assurance given to the participants that the raw data would remain confidential and would not be shared] but are available from the corresponding author on reasonable request. References Kim YS, Lee HY, Lee MH, Simms T, Park BH. 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Male Gender and Low Education with Poor Mental Health Literacy: A Population-based Study. J Epidemiol. 2007;17(4):114–9. https://doi.org/10.2188/jea.17.114 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 29 Jul, 2025 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Revision requested 09 Jun, 2025 Reviews received at journal 03 Jun, 2025 Reviews received at journal 27 May, 2025 Reviewers agreed at journal 20 May, 2025 Reviewers agreed at journal 20 May, 2025 Reviewers invited by journal 15 May, 2025 Editor assigned by journal 14 May, 2025 Submission checks completed at journal 11 May, 2025 First submitted to journal 11 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6554323","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":458701259,"identity":"459a904d-20a7-4ce6-9216-7e16020e08c9","order_by":0,"name":"Elif SARAÇ","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIie2PsWrDMBCGTwQ8GbIVGQ1+hUBAtGCcB+liY5Cn7hlMURZ7CeRJsnYWGDyp9SrIEi+ePQoCJXLcQhY76VaIvuU4+D/+OwCL5f/yPAdAHEAEZkEbcYeCPT4orFf4vUqPKIcxlfWLz6bTa4zhqcwbLetwX5SmJQtex5SFTJfeVhqFxMXSVYfkQ8ZGqdgbH1OAAUE5fjdKTqA7JFQYBfFyVPF37eyEvi8tuae7r4TWzbQCijkE8UHBrhIhVTdaFqp1XrYVxk5/mCuTiCrTEk384u/YTOkswHOStp6uwhWt0+bYZcH4Yb84PzO+JKNb8WtWfwlbLBbLY3AG6pxfljn80FQAAAAASUVORK5CYII=","orcid":"","institution":"The Ministry of National Defense of Turkiye","correspondingAuthor":true,"prefix":"","firstName":"Elif","middleName":"","lastName":"SARAÇ","suffix":""},{"id":458701260,"identity":"3e553980-32a4-4da2-93ca-4d63eb81b8db","order_by":1,"name":"Remziye CAN","email":"","orcid":"","institution":"The Ministry of National Education,Turkiye","correspondingAuthor":false,"prefix":"","firstName":"Remziye","middleName":"","lastName":"CAN","suffix":""},{"id":458701261,"identity":"66ed2477-2cba-4595-83f5-db45f2d7930c","order_by":2,"name":"Esra YILDIZ","email":"","orcid":"","institution":"Atatürk University","correspondingAuthor":false,"prefix":"","firstName":"Esra","middleName":"","lastName":"YILDIZ","suffix":""}],"badges":[],"createdAt":"2025-04-29 08:38:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6554323/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6554323/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-025-00845-7","type":"published","date":"2025-07-29T16:05:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":88268463,"identity":"100def34-52e5-447a-90a4-e41798a46685","added_by":"auto","created_at":"2025-08-04 16:51:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":902287,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6554323/v1/587b876b-969a-4886-9385-566f98e0b74d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mental Health Literacy Among Older Adults: A Cross-Sectional Study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eMental health literacy is a critical component in promoting mental health among older adults [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In addition to health literacy, individuals need general health knowledge to actively participate and make informed choices about their health [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Recently, the demand for mental health services and their utilization has significantly increased. This trend encourages individuals to seek psychological help for emotional, mental, and social problems experienced not only by themselves but also by their families [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Consequently, the importance of mental health literacy for older adults has grown even more.\u003c/p\u003e \u003cp\u003eMental health literacy (MHL) refers to people's knowledge and beliefs about mental disorders, their ability to recognize these disorders, and their understanding of help-seeking decisions [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This concept includes promoting mental health awareness and creating a supportive environment for people with mental disorders to facilitate early intervention. Improving MHL helps reduce stigma and discrimination and guides appropriate help-seeking behavior for those in need. Due to generally poor mental health literacy, mental disorders are often poorly recognized, leading to delays in treatment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Many studies have examined the MHL of community-dwelling people or clinical patients but have paid little attention to the MHL of older adults [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The lack of data on this issue necessitates a deeper understanding of MHL in older individuals [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Understanding the MHL of older adults is crucial for informing and improving mental health interventions and applications. By identifying gaps and strengths, targeted and effective training and applications can be developed.\u003c/p\u003e \u003cp\u003ePrevious studies have primarily focused on the MHL of depression and anxiety, rarely investigating the MHL of other mental disorders, such as psychosis and dementia [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Consequently, the MHL levels of the older adults regarding these other disorders are not well known. It is valuable and important to investigate whether older adults fully recognize and understand various mental disorders and whether they have positive attitudes and intentions toward helping those suffering from these disorders.\u003c/p\u003e \u003cp\u003eAdditionally, older adults, who now constitute the largest segment of society due to the increasing older population, may face involuntary hardships caused by decreasing income and rising health expenditures [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, mental health problems and the associated costs can be minimized by improving individuals' ability to recognize mental health issues and access necessary health services. Globally, the terms \"Health Literacy\" and \"Mental Health Literacy\" are used to emphasize the importance of understanding and processing health-related information to maintain one's health and effectively utilize health services [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Individuals who can read, interpret, understand, and apply healthcare information are better equipped to manage their health problems, require fewer health-related limitations, and experience lower degrees of disability compared to those without health literacy skills [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study has focused on assessing the level of mental health literacy among older individuals. Their understanding of mental health was measured, contributing new insights on the topic. This study is the first of its kind in our country, specifically targeting individuals aged 65 and over to determine their mental health literacy.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1.Type, Population and Sample of the Study\u003c/h2\u003e \u003cp\u003eThis observational cross-sectional study aimed to explore the mental health literacy of older adults. It was conducted in June 2024, involving 163 voluntary participants aged 65 and above in Erzurum, a city in eastern Turkiye. No specific sampling method was employed; the study aimed to include all individuals aged 65 and above who sought healthcare services at the hospital. The hospital serves as a regional center, catering to patients from the surrounding provinces of Kars, Agrı, Mus, Artvin, Bayburt, Erzincan, Gumuşhane, and Igdır, across all medical specialties.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2.Data Collection\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1.Demographic Characteristics Form\u003c/h2\u003e \u003cp\u003eThe form included information on age, sex, marital status, and education level.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2.Mental Health Literacy Scale-22-TR\u003c/h2\u003e \u003cp\u003eThe Mental Health Literacy Scale-22-TR was originally developed by O\u0026rsquo;Connor and Casey (2015) and adapted into Turkish by Goktas et al. (2019)[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The scale provides to measure the mental health literacy levels of people in community and consists of 22 items divided into three sub-groups: knowledge-based literacy, belief-based literacy, and resource-oriented literacy. The internal consistency coefficient of the original scale, as adapted by Goktas, was 0.71. Most items are affirmative statements, except for the belief-based literacy sub-dimension (items 11\u0026ndash;18). It is a six-point Likert scale ranging from 1 to 0 up to item 19. \u0026ldquo;Certainly agree\u0026rdquo; and \u0026ldquo;Agree\u0026rdquo; responses are scored as 1, while \u0026ldquo;Certainly disagree,\u0026rdquo; \u0026ldquo;Disagree,\u0026rdquo; and \u0026ldquo;Don't know\u0026rdquo; are scored as 0. Items 19 to 22 (resource-oriented literacy) are scored with \u0026ldquo;Yes\u0026rdquo; responses as 1 and \u0026ldquo;No\u0026rdquo; responses as 0. The total possible score on the scale ranges from 0 to 22. The Mental Health Literacy (MHL) scores and sub-dimensions are presented in \u003cb\u003eTable\u0026nbsp;1.\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable-1 Mental Health Literacy Scale and Sub-Dimensions\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eS. N.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMHLS-TR Sub-dimensions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eItems Numbers\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnowledge Based Literacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelief Based Literacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u0026ndash;18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResource Oriented Literacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u0026ndash;22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.3.Data Analyses\u003c/h2\u003e \u003cp\u003eData were evaluated using the SPSS (Statistics Program for Social Sciences) Windows Version 20.00 software package. The Kolmogorov-Smirnov (KS) test indicated that the data were normally distributed (p\u0026thinsp;=\u0026thinsp;0.000). Analyses included Cronbach's Alpha reliability test, Kolmogorov-Smirnov normality test, independent t-test, one-way ANOVA, and Pearson correlation analysis. Additionally, Games-Howell post-hoc analysis was conducted to determine the specific differences between effective factors. The mean scores of the scale and its sub-dimensions were calculated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.4.Ethics\u003c/h2\u003e \u003cp\u003e Informed consent was obtained from older adults who participated in the study after providing them with relevant information. Participants were informed that the confidentiality of their personal information would be protected, that they would not be held liable for any financial loss, and that they could withdraw from the study without giving any reason during the study. Ethical approval was obtained from the Clinical Research Ethics Committee of Ataturk University hospital medical school (date 7/6/24, approval number: 15). This study is reported in compliance with the Declaration of Helsinki. Additionally, permission to use the scale was obtained from Goktas et al.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Demographic Characteristics of Respondents\u003c/h2\u003e \u003cp\u003eThe study population comprised 41.7% women and 58.3% men, with an average age of 70.71\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35 years. The majority, 79.8%, were married, and 8.6% held a Bachelor's Degree. Detailed demographic characteristics are presented in \u003cb\u003eTable\u0026nbsp;2\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable-2. Demographic Characteristics of the Respondents\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003emean\u0026thinsp;\u0026plusmn;\u0026thinsp;sd\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e65 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e70.71\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e41.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e58.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e79.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e42.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e27.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor\u0026rsquo;s Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e163\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOrt\u0026thinsp;\u0026plusmn;\u0026thinsp;ss Min Max\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mean score of Knowledge Based literacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5.42\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mean score of Belief Based Literacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e4.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mean score of Resource Oriented L.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe mean score of MHLS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e12.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.2.Analyses of MHLS-TR\u003c/h2\u003e \u003cp\u003eThe highest score was observed in \"Knowledge-Based Literacy\" (5.42\u0026thinsp;\u0026plusmn;\u0026thinsp;2.51), while the lowest was in \"Resource-Oriented Literacy\" (2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.43). The total score for the MHLS-TR was 12.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68, with an internal consistency coefficient of 0.639 for the 22 items. Overall, older adults demonstrated a moderate level of MHL.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.3.Comparative Analysis of MHLS-TR Scores Across Demographic Characteristics\u003c/h2\u003e \u003cp\u003eStatistically significant findings from our study include a negative correlation between \"Knowledge-Based Literacy\" and age (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and a significant difference in \"Knowledge-Based Literacy\" based on marital status (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There was no significant difference observed between gender, MHLS-TR, and its sub-dimensions (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, a significant difference was found between education level and MHLS-TR scores (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Due to unequal variances, Games-Howell post-hoc analysis was conducted, revealing that individuals with a Bachelor\u0026rsquo;s degree had higher scores. Detailed results are presented in \u003cb\u003eTable\u0026nbsp;3\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable-3. Comparative Analysis of MHLS-TR Scores Across Demographic Characteristics\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEffective Factor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eMHL-TR\u003c/p\u003e \u003cp\u003eort\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKnowledge Based Literacy\u003c/p\u003e \u003cp\u003eort\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBelief Based Literacy\u003c/p\u003e \u003cp\u003eort\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResource Oriented Literacy\u003c/p\u003e \u003cp\u003eort\u0026thinsp;\u0026plusmn;\u0026thinsp;ss\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003cp\u003er\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.142\u003c/p\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.229\u003c/p\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003cp\u003e0.285\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.110\u003c/p\u003e \u003cp\u003e0.161\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.30\u0026thinsp;\u0026plusmn;\u0026thinsp;3.90\u003c/p\u003e \u003cp\u003e12.51\u0026thinsp;\u0026plusmn;\u0026thinsp;3.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.27\u0026thinsp;\u0026plusmn;\u0026thinsp;2.42\u003c/p\u003e \u003cp\u003e5.52\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e \u003cp\u003e4.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.85\u0026thinsp;\u0026plusmn;\u0026thinsp;1.36\u003c/p\u003e \u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003et\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.353\u003c/p\u003e \u003cp\u003e0.725\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.617\u003c/p\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.765\u003c/p\u003e \u003cp\u003e0.445\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.528\u003c/p\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMarried\u003c/p\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.63\u0026thinsp;\u0026plusmn;\u0026thinsp;3.66\u003c/p\u003e \u003cp\u003e11.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e5.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50\u003c/b\u003e\u003c/p\u003e \u003cp\u003e4.66\u0026thinsp;\u0026plusmn;\u0026thinsp;2.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58\u003c/p\u003e \u003cp\u003e4.51\u0026thinsp;\u0026plusmn;\u0026thinsp;2.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42\u003c/p\u003e \u003cp\u003e2.42\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003et\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.443\u003c/p\u003e \u003cp\u003e0.151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.951\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.050*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.404\u003c/p\u003e \u003cp\u003e0.687\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.011\u003c/p\u003e \u003cp\u003e0.313\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003cp\u003eLiterate\u003c/p\u003e \u003cp\u003ePrimary School\u003c/p\u003e \u003cp\u003eSecondary School\u003c/p\u003e \u003cp\u003eBachelor\u0026rsquo;sDegree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.57\u0026thinsp;\u0026plusmn;\u0026thinsp;4.01\u003c/p\u003e \u003cp\u003e11.93\u0026thinsp;\u0026plusmn;\u0026thinsp;3.20\u003c/p\u003e \u003cp\u003e13.54\u0026thinsp;\u0026plusmn;\u0026thinsp;3.22\u003c/p\u003e \u003cp\u003e\u003cb\u003e15.42\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e \u003cp\u003e5.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.39\u003c/p\u003e \u003cp\u003e5.82\u0026thinsp;\u0026plusmn;\u0026thinsp;2.86\u003c/p\u003e \u003cp\u003e\u003cb\u003e7.85\u0026thinsp;\u0026plusmn;\u0026thinsp;1.74\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.01\u0026thinsp;\u0026plusmn;\u0026thinsp;3.07\u003c/p\u003e \u003cp\u003e4.64\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e \u003cp\u003e4.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.92\u003c/p\u003e \u003cp\u003e3.64\u0026thinsp;\u0026plusmn;\u0026thinsp;1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e \u003cp\u003e2.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e \u003cp\u003e2.77\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55\u003c/p\u003e \u003cp\u003e\u003cb\u003e3.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF\u003c/p\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e6.207\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e6.394\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.634\u003c/p\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6.065\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003er: Correlation Analyses, F: One Way Anova Test, and Games Howel Post-hoc Analysis, t: Independent t test, *p\u0026thinsp;\u0026lt;\u0026thinsp;.05 statistical significance.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFurthermore, our study found significant positive correlations (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, 2-tailed) between the total MHLS-TR score and its sub-scales, indicating a consistent relationship across all dimensions of mental health literacy. Detailed findings are provided in \u003cb\u003eTable\u0026nbsp;4.\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable-4. Correlations Between Total Mental Health Literacy Scale and The Sub-scales\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal_MHL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKBL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBBL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eROL\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal_MHL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKBL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.742\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBBL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.528\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eROL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePearson Correlation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.334\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.237\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.319\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSig. (2-tailed)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e**. Correlation is significant at the 0.01 level (2-tailed).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis paper proposes to assess levels of MHL among older adults living in the community. The assessment aims to evaluate current MHL levels and to improve them where necessary. Importantly, these assessments are designed to be applicable across all cultural groups, acknowledging that older individuals have diverse relationships with mental health. While some may have a high level of MHL, characterized by accessibility, support, independence, experience, and confidence, many others do not share this experience.\u003c/p\u003e \u003cp\u003eThe study findings revealed that older adults generally exhibited a moderate level of MHL. Globally, empirical evidence suggests that MHL and attitudes towards mental health among the general population remain poor [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Despite ongoing efforts to improve these levels, there remains a pressing need to assess and enhance MHL specifically within the growing older population in communities.\u003c/p\u003e \u003cp\u003eThe study also found a significant and positive correlation between the total MHLS-TR score and its sub-scales. Consistent with previous research [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. increases in the total literacy score were mirrored by increases in knowledge, belief, and resource-oriented literacy levels. This finding underscores the expected relationship where higher overall literacy scores correspond to higher levels of specific literacy components in knowledge, belief, and resource access.\u003c/p\u003e \u003cp\u003eIn the present study, age was identified as a significant factor affecting \"Knowledge-Based Literacy\" among older adults, with MHL decreasing as age increases. This suggests that older individuals have limited information about mental health. This finding aligns with previous research indicating an inverse association between age and mental health literacy [\u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Interestingly, the study found no association between sex and MHL. This contrasts with some evidence suggesting that females generally have higher levels of knowledge and literacy compared to males [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Conversely, other recent research has suggested that females may have lower MHL [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. These discrepancies may be influenced by cultural factors and the average age of study participants. Indeed, similar findings to our study have been reported in the literature [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study, marital status was found to significantly influence MHL, with married individuals demonstrating higher levels compared to singles. This contrasts with recent findings suggesting that marital status is not a significant demographic characteristic affecting MHL [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The higher MHL among married individuals in our study may be explained by the cultural context where marriage often entails broader responsibilities and greater exposure to various topics, including mental health.\u003c/p\u003e \u003cp\u003eMoreover, our study highlighted the significant impact of education on MHL levels, with university graduates showing notably higher MHL scores. This finding aligns with previous research indicating that lower levels of education are associated with poorer MHL [\u003cspan additionalcitationids=\"CR25 CR26 CR27\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. These findings underscore the importance of identifying and supporting groups that may require additional assistance in improving their mental health literacy.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.1.Limitations\u003c/h2\u003e \u003cp\u003eDespite its strengths, the study had a number of limitations. The study participants were restricted to one university hospital in the east of Turkiye, which may limit the generalizability of the findings. The level of mental health literacy of the older adults ones was measured using their self-reporting, not their actual knowledge, skills, or behaviors. Therefore, the actual level of mental health literacy may be lower due to over-reporting because of the tendency for them to describe only their desirable attributes.\u003c/p\u003e \u003cp\u003eIn addition, in the questionnaire we could not ask so many questions related to demographic characteristics because of the sensitivity of the participants.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusions and Recommendations","content":"\u003cp\u003eThis study assesses the level of mental health literacy (MHL) among older adults, finding a moderate level among participants. Factors such as age, marital status, and education were identified as associated with MHL. The study emphasizes the importance of further investigating mental health help-seeking behaviors, MHL, and the stigma surrounding mental health. This exploration is crucial for effectively identifying older people with low MHL who would benefit from additional education or support.\u003c/p\u003e \u003cp\u003eThe findings underscore the ongoing need for communities to support the development of mental health literacy skills among older adults. By tailoring interventions based on age, gender, and place of residence, and by developing appropriate policies, both individual and societal MHL can be enhanced. This approach can empower individuals to better manage their own and their family members' mental health effectively.\u003c/p\u003e"},{"header":"Declarations","content":" \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eConceptualization: ES, RC,EY, Data curation; ES, RC,EY; Formal analysis: ES,EY; Methodology:ES, RC,EY; Resources:ES, RC,EY; Supervision:EY,EY; Visualization: ES, RC,EYWriting - original draft: ES; Review \u0026amp; editing:ES, RC,EY.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe thank to all participants and the manager of the hospital conducted in and to Goktas et al. who formed the MHLS in Turkish. Also we thank to the protranslate editing service for editing manuscript.\u003c/p\u003e\u003ch2\u003eData availability statements\u003c/h2\u003e \u003cp\u003eThe datasets generated during and/or analysed during the current study are not publicly available due [The confidentiality of the data used, the sensitive nature of the questions asked in the research, and the assurance given to the participants that the raw data would remain confidential and would not be shared] but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKim YS, Lee HY, Lee MH, Simms T, Park BH. Mental health literacy in Korean older adults: A cross-sectional survey. 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J Epidemiol. 2007;17(4):114\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2188/jea.17.114\u003c/span\u003e\u003cspan address=\"10.2188/jea.17.114\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mental Health, Literacy, Elderly","lastPublishedDoi":"10.21203/rs.3.rs-6554323/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6554323/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eMental health literacy refers to people's knowledge and beliefs about mental disorders, their ability to recognize them, and their knowledge of help-seeking decisions. There is a lack of knowledge regarding health literacy in older adults in Turkiye.\u003c/p\u003e\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eThe aim of current study is to measure the level of mental health literacy of older individuals and to create new grounds about the topic.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eFor this cross-sectional study, 163 cognitively healthy people aged\u0026thinsp;\u0026ge;\u0026thinsp;65 were included. Demographic characteristics form and \u0026ldquo;Mental Health Literacy Scale-TR\" were used to collect data. Age, marital status, and education were identified as associated with mental health literacy.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean age of participants was 70.71\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35. 41.7% of them were male and 8.6% of them had Bachelor's Degree. The mean score of Mental Health Literacy Scale-TR was 12.42\u0026thinsp;\u0026plusmn;\u0026thinsp;3.68.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eMental health literacy level of older adults was moderate.The findings underscore the ongoing need for communities to support the development of mental health literacy skills among elderly individuals.Additionally, present study emphasizes the importance of further investigating mental health help-seeking behaviors, and the stigma surrounding mental health.\u003c/p\u003e","manuscriptTitle":"Mental Health Literacy Among Older Adults: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-20 18:00:02","doi":"10.21203/rs.3.rs-6554323/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-09T17:51:10+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-03T12:44:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-27T11:45:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"299558248209395817964706138637432637582","date":"2025-05-20T10:16:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"10881275669157436912728285843754806169","date":"2025-05-20T08:48:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-15T19:28:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-14T13:50:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-11T20:30:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-05-11T20:28:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f68353f9-2e41-4557-9678-e59e99e98b9f","owner":[],"postedDate":"May 20th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-08-04T16:48:33+00:00","versionOfRecord":{"articleIdentity":"rs-6554323","link":"https://doi.org/10.1186/s12982-025-00845-7","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2025-07-29 16:05:16","publishedOnDateReadable":"July 29th, 2025"},"versionCreatedAt":"2025-05-20 18:00:02","video":"","vorDoi":"10.1186/s12982-025-00845-7","vorDoiUrl":"https://doi.org/10.1186/s12982-025-00845-7","workflowStages":[]},"version":"v1","identity":"rs-6554323","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6554323","identity":"rs-6554323","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}