Mental Health Literacy as a Methodology for Provincial-Scale Mental Health Prevention and Early Intervention in British Columbia

Abstract

Mental health presentations among children and youth are increasing globally and within British Columbia (BC). Early identification and intervention are critical, positioning Mental Health Literacy (MHL) as a key population-level strategy. MHL encompasses the knowledge, skills, and attitudes required to recognize mental health concerns, reduce stigma, and facilitate appropriate help-seeking. While MHL has been widely promoted across educational and community settings, less is known about how adults who support children—referred to in this study as "knowledge users" (parents, caregivers, and non-mental health professionals)—experience and apply MHL in real-world contexts. This study employed a community-engaged mixed-methods design to examine how knowledge users in BC understand, access, and use MHL, as well as the barriers and supports influencing its application. Quantitative data were collected from valid survey responses (N = 286) and qualitative data were gathered through two focus groups (N = 8), one with parents and caregivers and one with non-mental health professionals. Survey results indicate an existing gap in translating knowledge into practice, with the use of strategies learned from MHL training being the least frequently selected supportive action for addressing child and youth mental health concerns among participants (n = 126, 44.1%). Regarding perceived barriers to using MHL approaches, the most commonly reported were limited time or workload pressures (n = 160, 55.9%) and cost or access to services due to waitlists (n = 146, 51.0%), highlighting significant structural constraints. Bivariate analyses showed a statistically significant higher proportion of professionals than parents/caregivers reported limited time/workload pressures (n = 127, 60.2% vs. n = 33, 44.0%, p = .015), stigma or family resistance (n = 88, 41.7% vs. n = 12, 16.0%, p < .001), and unsure of legal/privacy limits (n = 35, 16.6% vs. n = 3, 4.0%, p = .006) as barriers. In contrast, a statistically significant higher proportion of parents/caregivers (n = 36, 48.0%) than professionals (n = 55, 26.1%) reported insufficient understanding on referral pathways as a barrier (p < .001). These findings demonstrate that barriers to MHL are not uniform but vary depending on participants' roles and positions within the system. Participants' preferred supports for using MHL aligned with reported barriers. The most valued were short modules/microlearning (n = 145, 50.7%) and workshops/coaching (n = 137, 47.9%), followed by clear referral tools (n = 114, 39.9%). Overall, these findings suggest that knowledge users prioritize applied, context-specific, and relational forms of learning. Qualitative findings further identified six themes: (1) MHL as structured learning of mental health symptoms; (2) application of MHL through frameworks and relational practice; (3) intervention constraints due to role ambiguity; (4) constraints due to perceived system strain; (5) need for MHL design that reflects everyday realities; and (6) a shift from individual knowledge toward connection and collective capacity. Participants from focus groups described challenges in translating knowledge into practice due to uncertainty in professional roles and limited service access. Effective application was supported through relational, context-responsive approaches, while participants emphasized the need for accessible, practical, and embedded resources. Grounded in an ecological systems framework, these findings highlight MHL as a socially situated practice shaped by interconnected individual, relational, and structural factors. MHL requires not only strengthening knowledge, but also addressing systemic barriers, improving service accessibility, and fostering relational support networks. Overall, this study shows that while knowledge users are motivated and engaged, their application of MHL is constrained by multilevel barriers. Bridging the knowledge-to-action gap through practical training, system navigation tools, and relational supports is essential to improve early identification and prevention of child and youth mental health concerns in BC.