Were you one of the more than 16,000 people who completed ABC's How 'mental health smart' are you? quiz a couple of years back?
If so, a team of Melbourne University researchers would like to thank you. Your answers have provided important insights that could help shape future mental health education campaigns.
"We certainly have data from large population surveys," said associate professor Nicki Reavley, one of a team of mental health experts the ABC approached for help in writing the survey, which was published in Mental Health week in 2015.
"But 16,000 people, you don't often get that many people filling out your questionnaire."
In return, the ABC agreed to provide data on audience responses — an opportunity the researchers relished.
The data, which did not include any information that could identify individuals, has now been analysed and published in the academic journal Advances in Mental Health: Promotion, Prevention and Early Intervention.
It shows we've come a long way in understanding some mental conditions like depression, but also reveals some important misconceptions remain in other areas, including anxiety disorders, psychosis and schizophrenia.
Psychosis involves disorganised thinking, and seeing or hearing things that aren't real. When episodes of psychosis are recurring, a diagnosis of schizophrenia may be made.
Gaps in knowledge
The quiz presented statements about different mental health conditions and respondents were asked if they agreed or disagreed with each.
"To recover from anxiety disorders, you have to face situations that provoke your anxiety," was the quiz item with the least correct responses; only 41 per cent of people knew this statement was correct.
And only 54 per cent of people knew that when someone was having delusions — believing something that isn't real — it was best not to try to reason with them.
In contrast 98 per cent of respondents knew exercise could help relieve depression.
"People are quite good on depression … they're much less likely to think someone's weak or that they can snap out of depression [than in the past]. Organisations like beyondblue have done a really good job in the past 20 years of raising awareness. But for anxiety and less common disorders like psychosis, I'd say there's a fair way to go.
"The question people did least well at was one that said if you're anxious about something, you should avoid the situation.
"Unless it's physically dangerous, evidence-based treatments [for anxiety] usually involve gradually increasing your exposure to whatever is the trigger for your anxiety."
And current evidence suggests that when someone is having delusions — say believing aliens come into their house at night and move their furniture — it's best not to try to talk them out of their belief using rational arguments.
"They can become more agitated and it's not necessarily going to be helpful," Dr Reavley said.
What we knew and what we didn't
Here's what the analysis of the How 'mental health smart' are you? quiz revealed about our knowledge of different mental problems:
% respondents who answered correctly
|Depression: exercise relieves
|Unconscious (drugs): lie on side
|Aggressive: speak firmly to calm
|Depression: force to seek help
|Suicide: asking gives the idea
|Psychosis: family prevent relapse
|Self-injury: avoid negative reaction
|Intoxicated: coffee, shower, walk
|Substance abuse: disapproval helps
|Trauma: Force to talk asap
|Panic: breathe into paper bag
|Psychosis: choices confuse
|Delusions: don't reason with
|Anxiety: provoke to recover
Obstacles to understanding
The fact psychosis affects only between 0.5 to 1 per cent of the population might explain why public understanding of the condition is lagging, Dr Reavley said.
"Not as many people know someone with psychosis or schizophrenia, so you don't have this personal reference point."
Knowing someone who's been diagnosed is often a trigger for friends and family learning about a condition and for breaking down stigmatising attitudes.
While anxiety is a much more common condition — it is about twice as common as depression in middle age for instance — it nonetheless presents its own unique challenges to being understood.
Because a little anxiety is often helpful — it can help motivate you for instance — it can be trickier for people to know when a threshold has been reached that means anxiety is excessive enough to qualify as a disorder.
"It's when anxiety tips over into having functional impacts on your life that it's a problem. If it stops you going to work, or to a wedding or something like that.
"Rarely is someone going to say a little bit of depression is a good thing. But it's just a little bit harder to see where the boundary is with anxiety."
Spot the early signs
Good mental health literacy is important because one in five people have a diagnosable mental health condition in a 12-month period.
"So there's a pretty good chance someone in your family or social circle is going to be affected."
Left untreated, mental disorders can reduce quality of life, cause social isolation and lead to suicide.
"The people in a person's social network, their friends and family, are going to be the ones that perhaps spot that something's going on.
"For someone to get help, the first step is them or someone else recognising there's a problem."
Mental Health First Aid
Just as there are courses in physical first aid, mental health first aid courses are now widely available.
In just a few hours people can learn enough to help them recognise a problem in others and steer the person in the right direction to get help, Dr Reavley said.
Courses run by Mental Health First Aid Australia have now reached about 2 per cent of the population, compared with about 11 per cent who have done physical first aid.
With some limitations, the findings from analysing the quiz results could be extrapolated to the broader Australian population, she said.
One limitation was that 64 per cent of respondents were female and this might have skewed the results as it's known women tend to have higher levels of mental health literacy than men.
Also, it's not known if respondents were more highly educated than average for Australia.