Construction of a mental health literacy evaluation index system for adolescents with mental disorders

Table 1 Indicator system for evaluating mental health literacy among adolescents with mental disorders

Indicators	mean ± SD	Coefficient of variation	Weights
Basic knowledge concepts (first-level indicators)	4.71 ± 0.47	0.10	0.2081
Knowledge of mental health (secondary indicators)	4.29 ± 0.77	0.18	0.2395
Knowing that mental health is an important component of health	4.82 ± 0.39	0.08	0.2324
Knowing that mental health mainly includes emotional stability, happy mood, and good adaptability	4.53 ± 0.51	0.11	0.0911
Know the characteristics of psychological changes during adolescence	4.94 ± 0.24	0.05	0.3144
Knowing the impact of bad moods on mental health	4.59 ± 0.51	0.11	0.1208
Knowing that regular sleep can help maintain mental health	4.47 ± 0.51	0.11	0.0676
Knowing that indulgence in online games can cause physical and mental illnesses	4.76 ± 0.44	0.09	0.1737
Knowledge of mental disorders (secondary indicators)	4.76 ± 0.44	0.09	0.6232
The earlier a mental disorder is treated, the better the outcomes	4.94 ± 0.24	0.05	0.3290
Knowing that one's illness can be alleviated and recovered after effective treatment	4.76 ± 0.44	0.09	0.2002
Knowing that they should take medication as prescribed by the doctor and should not adjust the dosage of medication arbitrarily or stop taking medication on their own	4.94 ± 0.24	0.05	0.3290
Knowing that taking psychotropic drugs can prevent the disease from deteriorating	4.71 ± 0.47	0.10	0.1418
Knowledge of risk factors (secondary indicators)	4.24 ± 0.75	0.18	0.1373
Knowing that self-injurious behaviors (cuts and burns) are likely to aggravate mental and psychological problems	4.53 ± 0.51	0.11	0.2345
Knowing that physical and psychological trauma (e.g., emotional, physical abuse, etc.) can lead to psychosomatic disorders	4.47 ± 0.51	0.11	0.1381
Knowing that poor lifestyles (smoking, drinking, and overeating) can negatively impact mental health	4.88 ± 0.33	0.07	0.4893
Knowing that excessive academic stress can lead to anxiety and depression	4.47 ± 0.51	0.11	0.1381
Mental health attitudes (first-level indicators)	4.88 ± 0.33	0.07	0.4063
Attitude toward the treatment of mental disorders (secondary indicators)	4.82 ± 0.39	0.08	0.3333
Willing to take medication according to the doctor’s recommendations for a long time	4.94 ± 0.24	0.05	0.3394
Willing to cooperate with the treatment and rehabilitation management of the hospital medical staff	4.76 ± 0.44	0.09	0.1367
Willing to undergo psychotherapy under the guidance of psychological counselors	4.88 ± 0.33	0.07	0.2214
Willing to participate in life skills training (e.g., making bed and cleaning clothes)	4.53 ± 0.51	0.11	0.0811
Willing to make positive lifestyle adjustments to improve mental health	4.88 ± 0.33	0.07	0.2214
Attitude toward seeking psychological help (secondary indicators)	4.88 ± 0.33	0.07	0.6667
Taking the initiative to seek psychological help from parents, friends, or teachers	4.65 ± 0.49	0.11	0.1631
Taking the initiative to communicate with school psychologists to alleviate emotional conflicts	4.65 ± 0.49	0.11	0.1631
Actively seeking help from community hospitals or local health organizations to manage illnesses	4.71 ± 0.47	0.10	0.2818
Taking the initiative to ask doctors about their diagnosis and treatment and query them on aspects they do not understand about the treatment measures	4.59 ± 0.51	0.11	0.1101
Willingness to seek professional assessment and diagnosis from mental health professionals (e.g., psychologists and psychiatrists)	4.71 ± 0.47	0.10	0.2818
Mental health behaviors (first-level indicators)	4.82 ± 0.39	0.08	0.2875
Social adaptive behaviors (secondary indicators)	4.65 ± 0.49	0.11	0.3333
Positively responding to anxiety-provoking events or circumstances	4.29 ± 0.47	0.11	0.0958
Compliance with daily therapeutic care activities	4.41 ± 0.51	0.11	0.1408
Actively participating in extracurricular school activities (e.g., singing and chess)	4.53 ± 0.51	0.11	0.2397
Ability to actively socialize with peers in class group activities	4.47 ± 0.51	0.11	0.1842
Active participation in classroom group activities (e.g., table tennis and crafts)	4.65 ± 0.49	0.11	0.3395
Mental health promotion behaviors (secondary indicators)	4.71 ± 0.47	0.10	0.6667
Frequent exchange of experience in disease self-management with patients having the same disease	4.53 ± 0.51	0.11	0.1561
Adjusting and controlling diets according to one’s own condition	4.41 ± 0.51	0.11	0.0869
Taking the initiative to learn scientific and effective ways to reduce stress to relieve psychological pressure	4.41 ± 0.51	0.11	0.0869
Correctly recognizing and accepting oneself and finding one’s own position	4.59 ± 0.51	0.11	0.2048
Actively participating in mental health education lectures	4.47 ± 0.51	0.11	0.1265
Taking the initiative to participate in physical exercises (e.g., indoor jumping exercise, eight-duanjin, and taijiquan)	4.82 ± 0.39	0.08	0.3386
Mental health skills (first-level indicators)	4.41 ± 0.71	0.16	0.0981
Emotional regulation skills (secondary indicators)	4.59 ± 0.62	0.13	0.4905
Can relieve the stress of the exam by deep breathing	4.59 ± 0.51	0.11	0.1174
Can talk to parents and friends about their worries	4.71 ± 0.47	0.10	0.1832
Reflecting on the causes of their own emotional loss	4.47 ± 0.51	0.11	0.0969
Can vent their emotions through crying	4.41 ± 0.51	0.11	0.0721
Can calmly cope with unexpected emergencies	4.35 ± 0.61	0.14	0.0551
Can restrain their own bad emotions and use diversion and distraction to vent their emotions	4.88 ± 0.33	0.07	0.2920
Can use relaxation techniques (e.g., listening to music and meditation) to regulate their emotions	4.71 ± 0.47	0.10	0.1832
Mental illness recognition skills (secondary indicators)	4.35 ± 0.61	0.14	0.1976
Knowing that a persistent state of low mood can be seen in depressive disorders	4.59 ± 0.51	0.11	0.2818
Knowing that anxiety disorders can be recognized by the presence of nervousness and panic attacks	4.59 ± 0.51	0.11	0.2818
Knowing that obsessive-compulsive thinking and behavior can be seen in obsessive-compulsive disorder	4.53 ± 0.51	0.11	0.1631
Knowing that abnormal thinking, emotion, will, and behavior can be seen in schizophrenia	4.47 ± 0.51	0.11	0.1101
Knowing that the presence of alternating low and high mood can be seen in bi-directional affective disorder	4.53 ± 0.51	0.11	0.1631
Ability to acquire mental health information (secondary indicators)	4.53 ± 0.72	0.16	0.3119
Can acquire mental illness knowledge through short video platforms (e.g., Douyin, Kuaishou)	4.59 ± 0.51	0.11	0.1239
Be able to use cell phones or computers to retrieve mental health information	4.82 ± 0.39	0.08	0.2449
Can read and understand mental health brochures in hospitals or clinics	4.53 ± 0.51	0.11	0.0863
Can obtain knowledge about mental illness by consulting medical workers	4.94 ± 0.24	0.05	0.3832
Can obtain knowledge about mental health through community, hospital, or school campaigns	4.65 ± 0.49	0.11	0.1617

Table 2 Item analysis results of the evaluation index system of mental health literacy in adolescents with mental disorders

Items	t value	r value	Item	t value	r value
A1.1	9.263b	0.547a	C1.3	10.357b	0.597a
A1.2	11.546b	0.554a	C1.4	12.646b	0.626a
A1.3	10.935b	0.558a	C1.5	10.169b	0.565a
A1.4	9.842b	0.517a	C2.1	11.404b	0.609a
A1.5	9.581b	0.508a	C2.2	11.049b	0.601a
A1.6	9.210b	0.515a	C2.3	10.297b	0.541a
A2.1	9.456b	0.535a	C2.4	10.256b	0.566a
A2.2	10.352b	0.548a	C2.5	11.656b	0.626a
A2.3	10.003b	0.556a	C2.6	11.274b	0.595a
A2.4	11.431b	0.600a	D1.1	9.921b	0.570a
A3.1	11.354b	0.547a	D1.2	8.475b	0.530a
A3.2	10.635b	0.597a	D1.3	11.876b	0.568a
A3.3	9.765b	0.542a	D1.4	8.814b	0.557a
A3.4	9.465b	0.552a	D1.5	11.205b	0.638a
B1.1	10.932b	0.613a	D1.6	12.093b	0.592a
B1.2	8.551b	0.462a	D1.7	8.994b	0.553a
B1.3	10.378b	0.555a	D2.1	9.780b	0.530a
B1.4	8.674b	0.523a	D2.2	11.589b	0.629a
B1.5	9.420b	0.523a	D2.3	11.875b	0.564a
B2.1	9.697b	0.533a	D2.4	10.956b	0.582a
B2.2	7.850b	0.486a	D2.5	10.487b	0.595a
B2.3	9.919b	0.544a	D3.1	10.343b	0.560a
B2.4	10.426b	0.572a	D3.2	9.180b	0.571a
B2.5	8.163b	0.483a	D3.3	9.803b	0.589a
C1.1	11.290b	0.589a	D3.4	10.023b	0.546a
C1.2	8.710b	0.505a	D3.5	11.406b	0.561a

^aP < 0.05.

^bP < 0.01.

Table 3 Characteristic values and variance contribution rates of common factors

Items	Extract the sum of squared loads			Rotating load sum of squares
	Total	Percent variance	Accumulate (%)	Total	Percent variance	Accumulate (%)
1	16.393	31.526	31.526	4.743	9.121	9.121
2	3.551	6.828	38.354	4.208	8.093	17.215
3	2.974	5.720	44.074	4.090	7.865	25.079
4	2.622	5.041	49.116	3.435	6.606	31.685
5	1.815	3.490	52.606	3.329	6.403	38.088
6	1.765	3.394	56.000	3.251	6.251	44.339
7	1.620	3.115	59.114	3.205	6.164	50.503
8	1.404	2.700	61.814	3.203	6.160	56.662
9	1.303	2.507	64.321	2.614	5.026	61.689
10	1.128	2.170	66.491	2.497	4.802	66.491

Factors 1 to 10 correspond to the following: (1) Knowledge of mental health; (2) Knowledge of mental disorders; (3) Knowledge of risk factors; (4) Attitude toward mental disorder treatment; (5) Attitude toward seeking psychological help; (6) Social adaptive behaviors; (7) Mental health promotion behaviors; (8) Emotional regulation skills; (9) Mental illness recognition skills; and (10) Ability to acquire mental health information.

Table 4 Rotation component matrix

Item	Ingredient
	1	2	3	4	5	6	7	8	9	10
41	0.784
39	0.767
42	0.731
40	0.709
37	0.701
36	0.689
38	0.650
6		0.783
5		0.780
4		0.765
3		0.743
1		0.695
2		0.680
33			0.784
35			0.770
32			0.735
34			0.720
30			0.705
31			0.660
29				0.786
28				0.773
26				0.748
25				0.693
27				0.677
24					0.764
23					0.761
21					0.736
20					0.722
22					0.628
19						0.756
18						0.742
17						0.722
15						0.685
16						0.645
51							0.771
48							0.716
52							0.708
50							0.654
49							0.626
47								0.742
46								0.734
45								0.694
43								0.673
44								0.627
8									0.748
10									0.737
9									0.698
7									0.619
13										0.722
12										0.717
14										0.685
11							0.639

Factors 1 to 10 correspond to the following: (1) Knowledge of mental health; (2) Knowledge of mental disorders; (3) Knowledge of risk factors; (4) Attitude toward mental disorder treatment; (5) Attitude toward seeking psychological help; (6) Social adaptive behaviors; (7) Mental health promotion behaviors; (8) Emotional regulation skills; (9) Mental illness recognition skills; and (10) Ability to acquire mental health information.