Mental health literacy and preferences of health care for common mental disorders using case vignette, among adults residing in Puducherry, southern India: Community-based explanatory mixed-method study.

Mental health is a global priority concern. The vast majority of people lack the ability to recognize mental illness and tend to have poor knowledge and attitude toward them. Help-seeking preferences even for common mental disorders remain unsatisfactory. To assess the mental health literacy level and health-seeking preferences for common mental disorders among adults above 18 years residing in rural and urban Puducherry. A cross-sectional explanatory mixed-method study was conducted, incorporating both quantitative and qualitative approaches. The quantitative component utilized a structured questionnaire administered through a multistage cluster random sampling technique. The Mental Health Literacy Scale (MHLS), comprising 35 items across six attributes, along with seven case vignettes, was employed to assess participants' ability to recognize common mental disorders and their preferences for health-seeking. The qualitative component involved two focus group discussions-one in a rural setting and one in an urban setting conducted using a mini-ethnographic approach. A total of 230 participants were surveyed. Responses to the survey indicated an average to poor level of mental health literacy (89.6%). There is adequate knowledge of professional help availability (73%) and where to seek information through resources such as general practitioners, friends, and Internet. However, most participants were inclined to hide (80%) their mental illness due to stigma. Only 14.3% and 9.4% could recognize generalized anxiety disorder and depression as mental illnesses, respectively. In the qualitative part, personal, family, social, and health system factors were identified as barriers to seek professional help for mental illness. The major barriers noted were trust in traditional/faith healers, stigma, low awareness, lack of trust, and confidentiality in the government sector. Mental health literacy among adults was inadequate, and they were unable to recognize common mental health disorders. Professional health-seeking behavior was low due to misconceptions, stigma, and lack of trust in the health system.