Mental health literacy among primary healthcare workers and its implications on detecting common mental health disorders across five geopolitical zones in Nigeria.

Mental health literacy among primary healthcare workers in Nigeria was low, with only 12.1% demonstrating above-average knowledge.

• Study sample consisted of 66 members of the National Association of Community Health Practitioners of Nigeria.
• Participants were drawn from five geopolitical zones in Nigeria.
• A cross-sectional, mixed-methods study design was used, employing a census method.
• Data were collected using a semi-structured questionnaire and Focus Group Discussions conducted among Community Health Practitioners in each zone.

Above-average mental health literacy was mainly associated with longer work experience and a family history of mental illness.

• Longer work experience was identified as a predictor of higher mental health literacy.
• Having a family history of mental illness was also identified as a predictor of above-average knowledge.
• These predictors were identified among the 12.1% of workers who demonstrated above-average knowledge.

Patients commonly presented to primary healthcare workers with physical complaints while underlying mental health conditions were often unrecognised.

• Common physical presentations included fever, headache, insomnia, weight loss, and weakness.
• Underlying mental health conditions including anxiety, depression, and substance use disorders were frequently missed.
• Routine mental health assessment was reported to be rare among primary healthcare workers.

Referrals to psychiatric services by primary healthcare workers were infrequent.

• Most workers reported only two to three referrals to psychiatric services in the past year.
• This pattern was identified across community health practitioners in the five geopolitical zones studied.
• The low referral rate is consistent with the low rate of routine mental health assessment reported.