Impact of Mental Health Literacy on Improving Quality of Life Among Adolescents in Barcelona

Abstract

Mental health literacy; Adolescents; Health education; School-based intervention

Alfabetització en salut mental; Adolescents; Educació per a la salut; Intervenció escolar

Alfabetización en salud mental; Adolescentes; Educación para la salud

We aim to assess the effect of the Espaijove.net mental health literacy program on adolescents' quality of life (QOL). Additionally, we aim to describe their QOL and mental well-being. Methods: A multicenter, randomized, controlled trial was conducted, with pre- and post-intervention assessments and 6- and 12-month follow-ups. A total of 1032 students aged 13-14 from 18 schools in Barcelona participated in one of the three following mental health literacy (MHL) programs or were placed in a control group (CG): (1) a 1 h awareness session (G1h); (2) a 6 h MHL program (G6h); (3) a 7 h MHL program with stigma reduction (G7h). Measures: (1) Mental well-being: Strengths and Difficulties Questionnaire (SDQ); (2) QOL: EuroQol 5D-5L with its two parts: the EuroQol 5D-5L Index (0-1) and EuroQol 5D-5L visual analog scale (EQ-VAS) (0-100). Analyses were conducted on an intention-to-treat basis, using data imputation methods for missing data. Intervention effects were assessed using multilevel models. Results: Baseline EQ-VAS and EQ-5D-5L index scores were 77.84 (CI = 76.77-78.91) and 0.91 (CI = 0.90-0.92), respectively. Boys reported higher QOL and SDQ scores (p < 0.001), whereas participants of foreign nationality showed lower scores in QOL (EQ-VAS; p = 0.039) and mental well-being (p < 0.001). Post-intervention, all groups (intervention and control), except G6h, showed QOL improvements. However, in the 6-month follow-up, the CG outperformed the other groups. At 12 months, G7h achieved the highest EQ-VAS scores compared to the other groups. Conclusions: MHL-based interventions improved short-term QOL but failed to sustain these improvements over time. Groups with lower QOL and SDQ scores included girls and adolescents of foreign nationality.

This research was funded by the folloqing: Instituto de Salud Carlos III. Subprograma de proyectos de investigación en salud (AES 2015), funded under grant code PI15/01613, co-financed by the European Union through the European Regional Development Fund (FEDER). Departament de Salut de la Generalitat de Catalunya dentro del Pla Estratègic de Recerca i Innovació en Salut 2016–2020 (PERIS), SLT002/16/00202. 20º beca Institut Català de la salut (ICS) per a la Capacitació en Investigació i Realització del Doctorat a l’Atenció Primària 2020, IDIAP 7Z20/010. Ajuts XB para la realización de la tesis doctoral para especialista de reciente titulación en Enfermería (promoción 2017–2019) familiar y comunitaria, 6ª convocatoria Gerencia territorial de Barcelona a través de la Unitat Docent Multiprofessional, Barcelona Ciutat, ICS, 2019. 15º Convocatòria d’Ajuts XB. Modul de Recerca. Unitat de Suport a la Recerca Barcelona Ciutat, 2023.