Mental health literacy and its relationship with suicidal tendencies mediated by social support in students: a school-based study

OBJECTIVE: Mental health challenges among adolescents have become a critical public health concern, particularly given the increasing prevalence of suicidal behaviours in this age group. While the relationships between mental health literacy, social support, and suicide risk have been studied globally, there is limited evidence from culturally specific contexts, particularly in less urbanized regions of Iran such as Khoy city. This study aimed to investigate mental health literacy) ability to understand and manage their own and others' mental health (and its relationship with suicidal tendencies, mediated by social support, among students. METHODS: This was a cross-sectional study conducted in 2024 in Khoy city, West-Azerbaijan, Iran. The study included 605 high-school students from six selected schools, who were selected through two-step random sampling.Mental Health Literacy, social support and suicide tendency questionnaires along with demographic information were used for data gathering. Data were analyzed using IBM SPSS AMOS Statistics 24 software. A structural equation modeling was employed to evaluate the relationships between the study variables and to test the conceptual framework. RESULTS: The structural model results revealed significant direct and indirect associations among the variables. Mental Health Literacy (MHL) positively influenced the social support (β = 0.135, P = 0.03), while socioeconomic status (SES) also had a positive effect (β = 0.203, P < 0.001). Social support was found to negatively affect suicide tendency (β = -0.823, P < 0.001). Although MHL did not directly impact suicide tendency, it had a significant negative indirect effect through social support (β = -0.112, P = 0.04). SES also indirectly reduced suicide tendency (β = -0.167, P < 0.001). Living with parents had a direct negative effect on suicide tendency (β = -0.081, P = 0.04). CONCLUSIONS: Based on the findings of this study, the importance of integrating mental health literacy into curricula, establishing peer support networks, and strengthening family-school collaboration within existing frameworks such as the WHO Action Plan is emphasized. Furthermore, these results may provide a foundation for developing localized guidelines aimed at enhancing mental health literacy and social support in schools; however, longitudinal and intervention studies are necessary to confirm the effectiveness of these recommendations.