Mental health disorders pose a global threat to public health and represent one of the most significant risks to overall wellbeing. The situation is particularly critical in low-income countries, such as those in Sub-Saharan Africa, where most of those in need of mental health care live. Primary healthcare plays a pivotal role in the treatment of mental health disorders, often serving as the first point of contact within the healthcare system. However, limited professional support and low mental health–related understanding among healthcare workers in these settings can make it difficult to provide adequate care for the population.

This study aimed to assess the psychometric properties of a mental health literacy instrument and to examine mental health literacy and its determinants among primary healthcare workers in Sub-Saharan Africa. The study formed part of a larger international development project that involved the design and implementation of a screening tool and supplementary training programme to enhance the recognition of mental health problems in children and adolescents. Within the framework of this doctoral research employing a mixed-methods approach, three sub-studies were conducted: a content validation study of the Mental Health Literacy Scale instrument, and two cross-sectional, survey-based studies across five administrative regions within primary healthcare settings in South Africa and Zambia.

The results of the study demonstrated that the revised instrument is both content-wise and structurally appropriate for measuring nurses’ perspectives on mental health problems as a comprehensive concept, for the first time in low-resource settings. The mental health literacy of primary healthcare workers was found to be moderate compared with previous research findings. The results revealed individual differences, particularly in attitudes towards mental health. Professionals with higher levels of education performed better than those with lower educational backgrounds. Prior exposure to routine practices involving mental health–related screening tools and assessment instruments appeared to influence the overall outcome and healthcare workers’ attitudes towards mental health issues. Moving forward, it is essential to strengthen impact research, research infrastructure, and higher education related to mental health within the region.