Survey shows poorer mental health knowledge in highly educated working males

Working males with tertiary education have significantly poorer knowledge of overall and subtle mental health symptoms compared with the general public, a recent population-based study in Hong Kong has shown.

Researchers from the Chinese University of Hong Kong and the Hong Kong Polytechnic University conducted population-based telephone surveys in 2015 and 2018 to examine the public’s knowledge of mental health symptoms and its association with help-seeking attitude. [Int J Ment Health Syst 2021;doi:10.1186/s13033-021-00462-2]

The surveys included 4,033 Hong Kong residents 12–75 years of age (male, 42 percent; mean age, 46.1 years). The respondents were asked to identify symptoms as mental illnesses from vignettes of anxiety disorders, mixed anxiety and depressive disorders (MADD), and dementia, and to recommend help-seeking methods (ie, nothing needs to be done, talking to family and friends, or consulting a doctor or seeking help from a professional). For each mental health condition, the respondents were presented with two vignettes, including one depicting more obvious symptoms with more constant intense feelings affecting daily function, and one describing subtle symptoms that are either contextual or intermittent.

A majority of respondents identified obvious symptoms of anxiety disorders (78.4 percent), MADD (71.4 percent), and dementia (76.7 percent). However, fewer identified subtle symptoms as mental illnesses (anxiety disorders, 59.7 percent; MADD, 36.1 percent; dementia, 48.9 percent).

Respondents with lower knowledge scores were more likely to be males (t=-5.0; <0.001), of younger age (F=15.0; p<0.001), have higher education (F=15.0; p<0.001), and employed (t=-2.1; p=0.037). Post hoc comparison showed that mean knowledge scores were the lowest in younger adults (age, 18-44 years) and those with tertiary education.

“Working males with tertiary education had significantly lower knowledge scores for overall [3.5 +/- 1.5 vs 3.8 +/- 1.4; t=3.9; p<0.001] and subtle mental health symptoms [1.3 +/- 1.0 vs 1.5 +/- 0.9; t=1.3; p<0.001] compared with the general public,” the researchers pointed out.

In terms of help seeking, subtle and obvious symptoms in the anxiety vignettes led 56 percent and 66 percent of the respondents, respectively, to recommended consulting a doctor or seeking help from other professionals. For MADD and dementia, the corresponding rates of recommending professional help were 69.6 percent and 59.7 percent, and 49.8 percent and 68.6 percent, respectively.

Of note, 22.7 percent of the respondents recommended doing nothing for subtle symptoms of dementia.

Respondents who were more knowledgeable about mental health symptoms were more likely to have a positive attitude towards seeking professional help. In contrast, those with poor mental health knowledge were less likely to recommend professional help in most of the vignettes.

“The survey results suggest significant implication to increase mental health knowledge of subtle symptoms, particularly in highly educated working males,” the researchers concluded. “More specific mental health information and intervention should be targeted at this hidden group for more sustained and significant impact on attitude change and knowledge enhancement.”

“Future public mental health education might start with male workers at managerial level, as they might have a higher chance to neglect subtle mental health symptoms and be less motivated to seek help from mental health professionals,” they added.