Health Literacy and Serious or Persistent Mental Illness: A Mixed Methods Study

Area of Science:

• Health Services Research
• Mental Health
• Health Literacy Studies

Background:

• Health literacy significantly impacts health outcomes, yet research on individuals with serious or persistent mental illness is limited.
• This population is particularly vulnerable to adverse health events, many of which are preventable.
• Understanding their specific health literacy strengths and needs is critical for targeted interventions.

Purpose of the Study:

• To evaluate the health literacy capabilities of adults with serious or persistent mental illness.
• To identify specific strengths and challenges in acquiring, understanding, and utilizing health information and services.
• To inform the development of effective health literacy interventions for this demographic.

Main Methods:

• A cross-sectional, mixed-methods design utilizing the Ophelia Access and Equity Framework.
• Quantitative data collected via the Health Literacy Questionnaire (HLQ) and WHO-5, alongside qualitative semi-structured interviews.
• Hierarchical cluster analysis grouped participants by health literacy scores to inform clinical vignette development.

Main Results:

• Participants faced challenges in appraising health information (HLQ mean 2.72) and navigating the healthcare system (HLQ mean 3.29).
• Positive experiences were reported regarding interactions with healthcare providers, with participants feeling understood and supported (HLQ mean 3.19).
• Cluster analysis indicated diverse health literacy profiles, negating a one-size-fits-all intervention strategy.

Conclusions:

• This study offers valuable insights into the health literacy landscape of individuals with serious or persistent mental illness.
• The Health Literacy Questionnaire (HLQ) proved acceptable for use with mental health clients.
• Findings underscore the need for patient-centered care approaches to address heterogeneous health literacy needs.