Mental health literacy in youth: a quasi-experimental comparison of a reusable learning object in Saudi Arabia and Malaysia.

BACKGROUND

Mental health disorders such as depression, anxiety, and stress are significant public health concerns, affecting 10-20% of adolescents globally. In Saudi Arabia and Malaysia, youth mental health issues are growing, yet Mental Health Literacy remains low. MHL encompasses recognizing mental disorders, seeking appropriate help, and understanding treatment options. Reusable Learning Objects (RLO), offer a promising solution to provide evidence-based education. However, studies on the effectiveness of RLO in different cultural settings are limited. This study employed a protocol of a cross-country comparison study aimed at evaluating the potential effectiveness of RLO in supporting Mental Health Literacy among youth in Saudi Arabia and Malaysia.

METHODS

A quasi-experimental design was employed among youth aged 16-24 years in two cities, Riyadh, Saudi Arabia, and Kuala Lumpur, Malaysia. RLO was developed using the ASPIRE methodology, and a validated English and Arabic MHL questionnaire was used in the study. Participants were assigned to intervention and control groups. The intervention group engaged with RLOs, while the control group completed the questionnaire without RLO exposure. Data were collected at baseline and post-intervention. Wilcoxon signed-rank tests compared baseline and post-intervention scores within groups, while Mann-Whitney U tests compared post-intervention change scores between countries.

RESULTS

Wilcoxon signed-rank analyses revealed significant improvements in MHL among participants in Saudi Arabia and Malaysia. In Saudi Arabia, improvements were observed across all domains, including a reduction in erroneous beliefs (p = .021). Mann-Whitney U tests showed that Malaysian participants achieved greater gains in mental health disorder knowledge (p < .001) and overall MHL (p = .002) compared to Saudi Arabian participants, with small-to-medium effect sizes. In Malaysia, large gains were found in mental health disorder knowledge, help-seeking/first aid skill, self-help strategies, and total MHL (p < .001), whereas changes in erroneous beliefs were not significant.

CONCLUSIONS

These findings highlight the promise of scalable, interactive RLOs for enhancing youth MHL in diverse cultural contexts, informing national digital mental health promotion strategies, school curricula integration, and policies to reduce stigma and improve early help-seeking in resource-constrained settings.