Literacy and mental health across the globe: a systematic review

Purpose: The purpose of this systematic review is to assess if there is a relationship between literacy abilities and mental health outcomes as reported in global literature. Fourteen percent of the global population has little or no literacy. Literacy skills impact on daily functioning and have been shown to impact on social outcomes. Whilst there has been research examining the potential association between literacy and mental health outcomes in specific populations, there has been no systematic review of this literature to date. Design/methodology/approach: A systematic review was carried out using Embase, PsycINFO and PubMed to identify relevant papers that measured both literacy and mental health. Data relating to the association between literacy and mental health were extracted. The papers included were assessed for quality using a bespoke quality rating tool. A narrative synthesis describes the findings. Findings: Nineteen studies from across nine countries were included in the analysis. Seventeen studies showed a significant association between literacy and mental health, those with lower literacy had greater mental health difficulties. Some papers reported factors that interacted with this association, such as age, gender, poverty and years of education. Originality/value: To the best of the authors’ knowledge, this is the first systematic review to look at the global picture of literacy and mental health. It suggests there is a relationship between literacy abilities and mental health outcomes, highlighting the importance of healthcare professionals and services including identification of literacy needs within routine mental health practice.