Mental health literacy and stigma among culturally and linguistically diverse adolescents in Australia: a comparative study

Purpose: Using baseline data from a large trial, this study examined general mental health literacy, mental health first aid intentions and actions, and stigmatising attitudes among culturally and linguistically diverse (CALD) adolescents in Victoria, Australia, compared to their non-CALD peers. Methods: Participants were senior secondary school students from diverse socioeconomic backgrounds. CALD adolescents (n = 426) spoke a language other than English at home, while non-CALD adolescents (n = 2,714) spoke only English. Outcomes were assessed using two vignettes depicting fictional characters with depression (with suicidal ideation) or anxiety. Multivariate linear or logistic regressions assessed the impact of CALD status on mental health literacy and stigma. P-values were adjusted using Holm’s method, where applicable, to mitigate the increased risk of Type I errors due to multiple comparisons. Results: Adolescents from CALD and non-CALD backgrounds showed similar help-seeking intentions for own mental health and willingness and confidence to assist peers. However, univariate and multivariate analyses consistently indicated that CALD adolescents were much less likely to recognise common mental health problems. Among CALD adolescents, 63.5% recognised depression with suicidal thoughts, compared with 84.2% of their non-CALD peers (odds ratio (OR) = 0.37 [95% CI: 0.21 to 0.63], p_adj < 0.001); similarly, only 37.3% of CALD adolescents correctly recognised anxiety, compared with 61.8% among non-CALD ones (OR = 0.54 [95% CI: 0.33 to 0.87], p_adj = 0.036). CALD adolescents also demonstrated significantly lower quality in helpful mental health first aid actions (β = -0.42 [95% CI: -0.70 to -0.14], p_adj = 0.006) and stronger “weak-not-sick” stigmatising attitudes (β was 0.32 [95% CI: 0.20 to 0.43] for depression and 0.23 [95% CI: 0.10 to 0.35] for anxiety, respectively). Conclusion: These results suggest significant disparities in multiple components of mental health literacy and stigma among CALD Australian adolescents compared to their non-CALD peers, underscoring the need for the development and implementation of targeted interventions to address these inequities.