Thriving Enough?: Mental Health Literacy among Norwegian Students

Strengthening young people’s resilience - their ability to adapt, cope, and recover from life’s challenges - is a key goal of education and public health policies in Norway.

Marina Chrisikopoulou

Head of Research

Andrea Bujor

Social Media Coordinator

---

One way to strengthen young people’s resilience is by increasing mental health literacy (MHL), with the hope that better knowledge can foster more open conversations, reduce stigma, and lower the threshold for seeking help when it is needed.

But before designing effective school-based MHL programs, we must first ask:

What is the current state of mental health literacy among Norwegian students?

Mental Health Literacy and the Norwegian School Context

In 2020, the Norwegian government introduced folkehelse og livsmestring (which can be translated to ‘public health and life mastery’) as an interdisciplinary theme across all school subjects. The aim is to help students develop the skills needed to manage everyday challenges and life transitions. This policy shift highlights schools as a key arena for strengthening mental health literacy but also raises questions about how this can be done in practice.

Mental health literacy (MHL) refers to our knowledge and beliefs about mental health, including the ability to recognise psychological distress, understand risk factors and causes, and know where and how to seek help (Kutcher et al., 2019). Importantly, it also includes understanding how to maintain good mental health and challenging stigmatizing attitudes toward oneself and others. 

Despite rising levels of psychological distress among adolescents, research suggests that young people’s mental health literacy remains relatively low, making school-based mental health literacy necessary (Bjørnsen et al., 2019).

The Human Aspect's Role: Lived Experiences in the Classroom

With initial support from SmartOslo, an initiative in Oslo municipality, we have been developing a free mental health literacy program built around digitalised lived experiences (DLEs). DLEs are video interviews where people describe their mental health challenges, coping strategies, and recovery journeys recorded by The Human Aspect.

These digital lived experiences are paired with ready-to-use lesson plans aligned with livsmestring and subject-specific learning goals (i.e. English, Social Science, Religion, and more). Check out our resources here. 

With recent support from Gjensidigestiftelsen, our work to integrate mental health literacy into Norwegian secondary schools through the use of DLEs has been significantly strengthened.

Our goal with developing a mental health literacy program was to reduce teachers’ workload while supporting students’ learning.

But first, we had to understand the well-being, stigmatizing attitudes, and the help-seeking behaviours and intentions of our target audience - this of Norwegian adolescents. This was done through a research study covering 3 Norwegian districts. 

The Study at a Glance

Participants

195 students in VG1 and VG2 (the first and second year of upper secondary education) from six high schools (vocational and university preparatory), across Oslo/Akershus, Trøndelag, and Innlandet.

Data collection

One survey session during school time (average completion time ~18 minutes).

Ethics

Approved by NSD/SIKT and Oslo municipality

Measures included

• Well-being: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) (1 = "none of the time" to 5 = "all of the time")

• Stigma:

  • Day’s Mental Illness Stigma Scale (1 = "strongly disagree" to 7 = "strongly agree")

  • Perceived public stigma (panic attack scenario) (1 = "strongly disagree to 5 = strongly agree")

  • Personal stigma (panic attack scenario) (1 = "strongly disagree" to 5 = "strongly agree")

• Help-seeking intentions: General Help Seeking Questionnaire (GHSQ) in two scenarios: emotional problems and suicidal thoughts (1 = "extremely unlikely" to 7 = "extremely likely")

• Plus two questions related to help seeking and two about their mental health knowledge

Findings

Student Well-Being - How have you felt in the past two weeks?

1 in 3 participants reported low mental well-being 

58% reported moderate well-being

There was a moderate level of well-being among participants, meaning that most participants exhibited average levels of well-being. However, a significant proportion (one in three participants), reported low mental well-being. Specifically, we found differences in gender, with adolescent females reporting lower mental well-being compared to males. 

Stigma - What do you really think about mental illness?

Perceived stigma: 49% of the participants thought “it would be too embarrassing” if they were experiencing panic attacks. And, 45% of the participants believed that they would be seen as weak

Personal stigma: 

64% of participants disagreed with the statement “I would think less of people with mental health challenges”

49% of participants disagreed with the following statement “Psychiatrists and psychologists have the knowledge and skills needed to effectively treat mental illnesses”

We looked at perceived stigma - the idea that others will judge you negatively for a trait or condition. On average, participants landed somewhere in the middle: not strongly stigmatizing, but not free of stigma either. Specific beliefs, though, were more widely held (see visuals above). Males reported significantly more perceived stigma than females.

But, here’s a hopeful part: most participants didn’t think the important people in their lives would view them less favourably because of a mental health challenge, highlighting the importance of interpersonal connections. 

We also explored personal stigma - how people view others with mental health challenges. Most participants didn't endorse discriminatory or blaming beliefs, though men reported significantly higher personal stigma than women.

Stigma toward mental illness more broadly told a similar story: Most participants rejected harmful stereotypes about the trustworthiness of people with mental health challenges or the relationship potential with those with mental health challenges. 

One finding stood out: many participants weren’t confident that mental health professionals could effectively treat mental illness. Such doubt could impact whether young people seek help. 

Help-Seeking Intentions - Who would you turn to?

1 in 3 participants were not sure they would get help if experiencing a mental health problem 

In the likelihood of an emotional problem, students were more likely to seek support from informal sources such as a partner (54%) or a parent (47%) than a formal source such as a doctor (22%)

In the scenario of suicidal thoughts 22% of participants said it was unlikely they'd seek help from a mental health professional

Most participants felt confident they knew where to get help but weren’t certain they’d actually reach out if they needed it.

Using a standard help-seeking questionnaire (GHSQ), we asked participants how likely they'd be to seek help in two scenarios: if they had emotional problems and if they had suicidal thoughts. Participants were slightly more willing to reach out for emotional problems than for suicidal thoughts, though the difference was small. In both cases, around 1 in 5 said they were unsure whether they'd seek help at all.

When asked who they'd actually turn to, participants leaned toward informal support.

Males and females didn't differ significantly in their help-seeking intentions, in either scenario. That's worth noting but it's also worth remembering that we measured intentions, not behaviors and there's often a gap between wanting help and reaching for it.

How can this knowledge help us design better programs?

Taken together, our findings point to how mental health literacy (MHL) programs can be better tailored to the needs of Norwegian adolescents. 

On well-being: Female participants reported lower mental well-being than males. MHL programs may want to explore and address the factors that could be driving this gap, including the impact of traditional gender and social norms, biological factors, and gender equality. 

On stigma: MHL programs should focus not only on reducing personal stigma, but also on highlighting the power of supportive connections, for example through stories of people who have been lifted up by those around them. This could be integrated using THA video material. Perspective-taking activities can also help challenge lingering negative attitudes toward people with mental health challenges.

To address the doubt concerning the efficacy of mental health professionals, MHL programs should facilitate discussion about treatment options, real outcomes, and real stories. Hearing from people who've benefited from professional support could make help-seeking feel more within reach - THA video could again be used.

On help-seeking: Many participants were unsure whether they'd reach out for help, and most leaned toward informal sources over formal ones. This matters in the Norwegian context, where formal mental health support is relatively accessible, including in schools (school nurse). MHL programs in these familiar settings could help bridge the gap, but only if they go beyond listing resources to actually showing what reaching out can look like. This can be done by sharing stories (such as the THA video) that encourage connection and by promoting role models who've taken that step themselves.

The Bottom Line

If mental health literacy programs want to move young people from knowing about mental health to acting on it, lived experiences, such as The Human Aspect's video, may be one of the most powerful tools available.

 

By integrating lived experiences into classrooms, mental health education becomes relational, engaging, and memorable, not just informational.

Research

About the Author

This article was written by Marina Chrisikopoulou and Andrea Bujor, at THA. In our aim to redefine mental health, THA develops innovative programs to reduce stigma and increase help-seeking.

References

Bjørnsen, H. N., Espnes, G. A., Eilertsen, M. E. B., Ringdal, R., & Moksnes, U. K. (2019). The relationship between positive mental health literacy and mental well-being among adolescents: implications for school health services. The Journal of School Nursing, 35(2), 107-116.

Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. The Canadian Journal of Psychiatry, 61(3), 154-158.

Utdanningsdirektoratet. Folkehelse og livsmestring. https://www.udir.no/lk20/overordnet-del/prinsipper-for-laring-utvikling-og-danning/tverrfaglige-temaer/folkehelse-og-livsmestring/ 

Utdanningsforskning. (2024). Undervisning om livsmestring- lærerne har tatt oppgaven på alvor. https://utdanningsforskning.no/artikler/2024/undervisning-om-livsmestring--larerne-har-tatt-oppgaven-pa-alvor/