Parent-child mental health literacy discordance and adolescent depression and anxiety: a population-based cross-sectional study.

Abstract

Background: The patterns of family-level mental health literacy (MHL) and their associations with adolescent depression and anxiety are not well understood. This study investigated the alignment of MHL between parents and children and its correlation with adolescent depression and anxiety, as well as identified factors linked to family MHL patterns.

Methods: We conducted a cross-sectional survey of 4633 parent-child dyads using multi-stage stratified sampling across eight cities in Guangdong Province, China. Family MHL and adolescent depression and anxiety symptoms were measured. Multinomial logistic regression identified factors associated with family MHL patterns, while linear regression models examined associations between proficiency patterns and adolescent mental health outcomes.

Results: Only 4.73% of parent-child dyads were both proficient in MHL, with slight concordance (κ = 0.169, 95% CI 0.141-0.197) and adolescents exhibited higher proficiency rates than parents (18.52% vs. 13.27%). Being in senior high school grade and rural residence were associated with child-only proficiency patterns. The quality of parental relationships was associated with patterns of proficiency in parents only. Rural residence and the quality of parental relationships were associated with mutual non-proficiency. Compared to mutual proficiency, mutual non-proficiency and parent-only proficiency were associated with increased symptoms of depression and anxiety in adolescents. Interactions were found between family literacy patterns and the quality of parent relationships.

Conclusions: Parents and children exhibit significant inconsistencies in MHL, with generational gaps present in most families. Interventions that focus on child-centered schools incorporating family involvement, could leverage adolescents' higher literacy and simultaneously enhance family relationships to foster better mental health.

Implications and contribution: Little is known about parent-child dyadic patterns of MHL and their associations with adolescent depression and anxiety. Using population-based sample, this study found that family mental health literacy concordance is low. Parental mental health literacy deficits were associated with increased adolescent depression and anxiety risks .