Adolescence represents a formative developmental stage marked by profound emotional, psychological, and social transitions. During this period, individuals undergo rapid changes in self-concept, peer relationships, and academic demands, which may heighten susceptibility to psychological stress and mental health difficulties [3]. At a global level, common mental health conditions such as anxiety and depressive disorders constitute leading contributors to disease burden and functional impairment among adolescents. In Thailand, growing attention has been directed toward adolescent mental health, particularly within school contexts where academic competition and social expectations are substantial.

Mental health literacy refers to the ability to recognize mental health concerns, understand available sources of support, and make informed decisions regarding help-seeking. Higher levels of mental health literacy have been associated with improved recognition of psychological distress, reduced stigmatizing attitudes, and increased engagement in adaptive help-seeking behaviors. Nevertheless, existing evidence suggests that many adolescents experience difficulty distinguishing between normative stress responses and clinically relevant mental health conditions, including depressive disorders. Inadequate mental health knowledge, combined with concerns about negative social evaluation, may discourage adolescents from seeking professional assistance even when support services are accessible.

The widespread adoption of social media has further complicated the mental health landscape for adolescents. Digital platforms [4] offer opportunities for social connection, peer support, and access to mental health–related information. However, excessive or unregulated use has also been associated with heightened psychological strain, social comparison, and emotional vulnerability. Although a substantial body of literature has examined the adverse psychological consequences of social media exposure, comparatively fewer studies have explored whether the intensity of social media use is directly related to adolescents’ mental health literacy or their readiness to seek help. Findings in this area remain inconsistent, particularly within Southeast Asian populations.

Educational institutions constitute a key social environment influencing adolescents’ perceptions of mental health. A supportive school context [5], characterized by positive teacher–student relationships, accessible support services, and an atmosphere that normalizes discussion of psychological concerns [6], may facilitate healthier attitudes toward mental health and promote help-seeking behaviors. In Thailand, school-based mental health initiatives have increasingly been recognized as an important preventive strategy. However, empirical research examining how school-related psychosocial factors interact with social media use to shape mental health literacy and help-seeking behaviors among adolescents remains limited. Accordingly, the present study aimed to investigate the relative influence of school and social factors and social media use on mental health literacy [7,8] and help-seeking behaviors among Thai adolescents.

2. Methodology

2.1 Study Design and Participants

A cross-sectional survey approach was utilized to examine factors associated with mental health literacy and help-seeking behaviors among adolescents. The study sample consisted of 128 Thai secondary school students, with a mean age of 16 years. Participants were recruited from a secondary school in Thailand using a convenience sampling method. Participation was entirely voluntary, and data were collected anonymously to protect respondent confidentiality [9]. Questionnaires with missing or incomplete responses were excluded from the final analysis to ensure data quality and analytical validity.

2.2 Data Collection Instrument

Data were obtained through a structured, self-administered questionnaire designed with reference to existing literature on adolescent mental health literacy and help-seeking behaviors [10]. The instrument comprised four main components:

1. Sociodemographic information, including age and gender
2. Patterns of social media engagement [11], assessed by self-reported average daily time spent on social media platforms [13]
3. Mental health literacy measures [12,15], evaluating participants’ capacity to differentiate normative stress responses from depressive symptoms, as well as their awareness of available mental health support resources
4. Help-seeking attitudes and behaviors, including stigma-related perceptions [14] and perceived availability of mental health support within the school environment

All mental health–related items were rated on a five-point Likert scale [17], ranging from 1 (strongly disagree) to 5 (strongly agree). Higher composite scores reflected greater mental health literacy [18], more favorable attitudes toward help-seeking [16], and lower levels of stigmatizing beliefs.

2.3 Variable Definition

– Mental Health Literacy was calculated as the mean score of two items assessing the ability to distinguish normal stress [19] from depression and knowledge of where to seek help.

– Help-Seeking [16] Readiness was calculated using items related to willingness to seek help and perceived encouragement from the school environment.

– Stigma Reduction Attitude was assessed using an item measuring beliefs about the role of school education in reducing mental health stigma.

– Social Media Use was measured as self-reported average daily usage in hours.

– Perceived school environmental support was assessed using an item evaluating the extent to which the school climate promotes open communication and facilitates students’ willingness to seek support for mental health–related concerns.

2.4 Statistical Analysis

Data analysis was conducted using statistical software with functionality equivalent to SPSS. Descriptive statistics, including means and standard deviations, were computed to summarize participant demographics and mental health–related variables. Associations between levels of daily social media use and mental health literacy were examined using the chi-square test.

An independent samples t-test was initially considered to evaluate gender-based differences in stigma-related attitudes and help-seeking behaviors. However, due to an unequal gender distribution within the sample, inferential analyses by gender were interpreted with caution and were not emphasized. Multiple linear regression modeling was subsequently applied to examine factors associated with mental health literacy, with social media use, gender, and perceived school environmental support entered as independent variables [23]. A two-tailed significance level of p < 0.05 was adopted for all statistical tests.

2.5 Ethical Considerations

The study was conducted in compliance with established ethical standards for research involving human participants. Participation was entirely voluntary, and informed consent was obtained prior to data collection. All responses were collected anonymously, and strict measures were implemented to safeguard participant confidentiality. The research involved minimal risk, as it focused on the assessment of general mental health–related attitudes and perceptions without the collection of personally identifiable information.

3. Results

3.1 Participant Characteristics

The study included a total of 128 adolescent participants, most of whom were 16 years old and female. Daily social media use ranged from 3 to more than 7 hours per day, with the largest proportion of students reporting 5–7 hours of social media use per day, indicating high digital engagement [21] among the study population.

3.2 Summary Statistics for Mental Health Measures

Table 2 provides a summary of descriptive statistics across mental health domains.Overall, mental health literacy scores indicated a moderate to high level among participants (mean = 3.99, SD = 0.83). Help-seeking readiness was relatively high (Mean = 4.18, SD = 0.75), suggesting generally positive attitudes toward seeking mental health support. Attitudes toward stigma reduction were also positive (Mean = 4.06, SD = 1.12), indicating that most participants believed school education [20] could help reduce mental health stigma.

3.3 Association Between Social Media Use and Mental Health Literacy

A chi-square analysis was performed to assess the relationship between levels of daily social media engagement and mental health literacy. For analytical purposes, mental health literacy scores were dichotomized into higher and lower categories, while social media use was classified according to average daily duration. The analysis revealed no statistically significant association between social media use and mental health literacy (χ² = 0.76, p = 0.69). Across all categories of social media engagement, participants demonstrated comparably high levels of mental health literacy, indicating that literacy levels were not dependent on the extent of social media use.

3.4 Gender Differences in Stigma and Help-Seeking Behaviors

An independent samples t-test was initially considered to examine potential gender-related differences in stigma-related attitudes and help-seeking behaviors. However, due to a highly imbalanced gender distribution, inferential statistical comparison was limited. Descriptive trends suggested that female participants reported slightly higher scores in help-seeking readiness and stigma-reduction attitudes than male participants. These findings should be interpreted with caution.

3.5 Predictors of Mental Health Literacy

Multiple linear regression modeling was conducted to examine factors associated with mental health literacy (Table 4). The overall model demonstrated statistical significance (F(3,124) = 3.41, p < 0.01) and accounted for 7.6% of the variance in mental health literacy scores.

Perceived support within the school environment was independently associated with higher mental health literacy (β = 0.28, p = 0.002). In contrast, the amount of daily social media use showed no significant association with mental health literacy (β = −0.04, p = 0.687). Gender was not retained as a meaningful explanatory variable due to limited variability within the sample.

Figure 2 illustrates the interaction between daily social media use and the school mental health consultation environment in predicting mental health literacy. Adolescents in schools with a high consultation environment consistently demonstrated higher mental health literacy across all levels of social media use, whereas those in low consultation environments showed lower literacy levels.

3.6 Summary of Key Findings

The results reveal that while Thai adolescents tend to hold favorable views on mental health and help-seeking, the school environment exerted a greater impact on their mental health literacy than social media engagement. This emphasizes the value of implementing school-centered mental health initiatives.

4. Discussion

The present study explored the relative contributions of social media engagement and school-related contextual factors to mental health literacy and help-seeking behaviors among Thai adolescents. Overall, participants demonstrated moderate to high levels of mental health literacy, accompanied by generally favorable attitudes toward help-seeking and stigma reduction. Notably, the findings indicate that characteristics of the school mental health consultation environment exert a stronger influence on mental health literacy than the duration of social media use.

Contrary to commonly held concerns, the frequency of social media use was not significantly associated with mental health literacy. Adolescents reporting lower and higher levels of daily social media engagement exhibited comparable levels of mental health knowledge and awareness. This pattern aligns with emerging evidence suggesting that exposure duration alone may be insufficient to account for mental health–related outcomes. Instead, broader psychosocial and educational contexts may play a more central role in shaping adolescents’ understanding of mental health. The absence of a clear linear association was further supported by regression diagnostics and residual analyses, reinforcing the robustness of this finding.

In contrast, perceived support within the school mental health consultation environment emerged as a salient factor associated with higher mental health literacy. Adolescents who viewed their schools as accessible, responsive, and open to mental health–related dialogue reported greater understanding and awareness of mental health issues [25]. Moreover, interaction analyses suggested that a supportive consultation environment functioned as a protective contextual factor across varying levels of social media use. This buffering pattern highlights the importance of school climates that normalize mental health discussions and reduce perceived barriers to seeking assistance.

Although female students demonstrated slightly higher descriptive scores in help-seeking attitudes and stigma-related perceptions, inferential gender comparisons were constrained by the unequal gender distribution within the sample. This limitation underscores the need for future investigations with more balanced samples to clarify potential gender-specific patterns in adolescent mental health literacy and help-seeking behaviors [25]. Additionally, the relatively modest proportion of variance explained by the regression model suggests that mental health literacy is shaped by a constellation of influences beyond those examined in the present study. Factors such as family dynamics, peer relationships, cultural norms, and individual coping capacities warrant further exploration.

Collectively, these findings underscore the pivotal role of schools as primary settings for adolescent mental health promotion. Rather than emphasizing reductions in social media use alone, preventive strategies may be more effective if they prioritize the development of supportive school mental health consultation systems, enhance access to guidance and counseling services, and foster an educational climate characterized by openness and psychological safety. Such school-centered approaches have the potential to strengthen mental health literacy and facilitate earlier, more adaptive help-seeking behaviors among adolescents.

5. Conclusion

This study investigated the roles of social media engagement [23] and the school mental health consultation context in relation to mental health literacy and help-seeking behaviors among Thai adolescents. The findings indicate that the majority of participants demonstrated relatively well-established mental health literacy alongside positive orientations toward seeking support. Importantly, these outcomes appeared to be more closely associated with school-based contextual conditions than with the duration of social media use.Notably, social media engagement in isolation was not independently associated with levels of mental health literacy.Instead, the school mental health consultation environment emerged as a key determinant, both as a direct predictor and as a moderating factor. Adolescents who perceived their schools as open, accessible, and supportive of mental health consultation consistently showed higher mental health literacy across all levels of social media use. This suggests that a strong consultation environment may buffer potential negative influences associated with high digital exposure.

These findings highlight the critical role [26] of schools as primary settings for adolescent mental health promotion. Strengthening school-based mental health consultation systems, improving access to trusted guidance, and fostering a culture [29] that encourages open discussion without stigma may be more effective strategies than focusing solely on reducing social media use. Such approaches can enhance adolescents’ ability to recognize mental health problems [27] and seek appropriate help at an early stage.

In conclusion, promoting a supportive school mental health consultation environment should be considered a central component of adolescent mental health policies and interventions in Thailand. Future efforts should prioritize integrated, school-based strategies that empower adolescents with knowledge, confidence, and accessible support systems to promote long-term [30] mental well-being.

References

1. Miles, R.T., Krishnan, A., Rabin, L.A. et al. Does major make a difference? Mental health literacy and its relation to college major in a diverse sample of undergraduate students. Discov Ment Health 4, 42 (2024). https://doi.org/10.1007/s44192-024-00099-w
2. Tian Y, Shi Z. The Relationship between Social Support and Exercise Adherence among Chinese College Students during the COVID-19 Pandemic: The Mediating Effects of Subjective Exercise Experience and Commitment. Int J Environ Res Public Health. 2022 Sep 19;19(18):11827. doi: 10.3390/ijerph191811827. PMID: 36142099; PMCID: PMC9517627.
3. Asplund, A., & Göransson, K. (2025). Promoting mental health literacy of 13–16-year-old students: A systematic review of school-based interventions. International Journal of Environmental Research and Public Health, 22(10), 1578. https://doi.org/10.3390/ijerph22101578
4. Ekvitayavetchanukul, P., Bhavani, C., Nath, N., Sharma, L., Aggarwal, G., Singh, R. (2024). Revolutionizing Healthcare: Telemedicine and Remote Diagnostics in the Era of Digital Health. In: Kumar, P., Singh, P., Diwakar, M., Garg, D. (eds) Healthcare Industry Assessment: Analyzing Risks, Security, and Reliability. Engineering Cyber-Physical Systems and Critical Infrastructures, vol 11. Springer, Cham. https://doi.org/10.1007/978-3-031-65434-3_11
5. Ekvitayavetchanukul, P., & Ekvitayavetchanukul, P. (2025). AI-Driven Design Thinking: Transforming Learning Efficiency in Pre-Medical Education. Medical Research Archives, 13(4). https://doi.org/10.18103/mra.v13i4.6410
6. Ekvitayavetchanukul, P., & Ekvitayavetchanukul, P. (2023). Comparing the effectiveness of distance learning and onsite learning in pre-medical courses. Recent Educational Research, 1(2), 141-147.  https://doi.org/10.59762/rer904105361220231220143511
7. Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10, 113. https://doi.org/10.1186/1471-244X-10-113
8. Setia Lesmana, M. H., & Chung, M.-H. (2024). Mediating roles of perceived stigma and mental health literacy in the relationship between school climate and help-seeking behavior in Indonesian adolescents. PLoS ONE, 19(5), e0298017. https://doi.org/10.1371/journal.pone.0298017 PLOS
9. Mathasuriyapong, P., Korcharlermsonthi, N., Ekvitayavetchanukul, P., & Ekvitayavetchanukul, P. (2025). Modeling the health burden of PM2.5: Forecasting hospital admissions and medical demand in Bangkok and neighboring regions. Journal of Posthumanism, 5(6), 862–873. https://doi.org/10.63332/joph.v5i6.2155
10. Marengo, D., Longobardi, C., Fabris, M. A., & Settanni, M. (2021). Highly- visual social media and internalizing symptoms in adolescence: The mediating role of body image concerns. Computers in Human Behavior, 122, 106862. https://doi.org/10.1016/j.chb.2018.01.003
11. Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the prevalence and treatment of mental disorders among U.S. adolescents: 2008–2014. Journal of the American Academy of Child & Adolescent Psychiatry, 55(1), 52–63. https://doi.org/10.1016/j.jaac.2015.10.010
12. Nobre, J., Calha, A., Luis, H., Oliveira, A. P., Monteiro, F., Ferré-Grau, C., & Sequeira, C. (2022). Mental health literacy and positive mental health in adolescents: A correlational study. International Journal of Environmental Research and Public Health, 19(13), 8165. https://doi.org/10.3390/ijerph19138165
13. Nazari, A., Askari, A., Rahimi Foroushani, A., & Garmaroudi, G. (2024). The effect of educational intervention based on social media on mental health literacy of high school students: Study protocol. Frontiers in Psychology, 15, 1377760. https://doi.org/10.3389/fpsyg.2024.1377760
14. Odgers, C. L., & Jensen, M. R. (2020). Annual Research Review: Adolescent mental health in the digital age: Facts, fears, and future directions. Journal of Child Psychology and Psychiatry, 61(3), 336–348. https://doi.org/10.1111/jcpp.13190
15. Rickwood, D. J., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2005). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 60(3), 181–188. https://doi.org/10.5172/jamh.4.3.218
16. Rickwood, D., & Bradford, S. (2012). The role of mental health literacy in help-seeking. Australian Psychologist, 47(1), 19–28. https://doi.org/10.1111/j.1742-9544.2011.00034.x
17. Sala, A., Porcaro, L., & Gómez, E. (2024). Social media use and adolescents’ mental health and well-being: An umbrella review. Computers in Human Behavior Reports, 100404. https://doi.org/10.1016/j.chbr.2024.100404 ScienceDirect
18. Seedaket, S., & Wichaikhum, O. (2020). Improving mental health literacy in adolescents: A systematic review. Tropical Medicine & International Health, 25(11), 13449. https://doi.org/10.1111/tmi.13449
19. Sun, G., & Lee, Y. (2025). Effectiveness of mental health literacy interventions for adolescents: A meta-analysis. SAGE Open, 15(1), 21582440251327445. https://doi.org/10.1177/21582440251327445
20. Sutabutra, T., Rujachan, P., Manasakorn, K., Sripetchnai, M., & Ekvitayavetchanukul, P. (2025). The impact of design thinking vs rote learning on secondary student achievement: An experimental study in Bangkok schools. Asian Journal of Education and Social Studies, 51(2), 411–422. https://doi.org/10.9734/ajess/2025/v51i21794
21. Stauch, L., & Richter, F. (2025). Digital health literacy of children and adolescents and its determinants: A national study. Journal of Medical Internet Research, 27, e69170. https://doi.org/10.2196/69170
22. Tynes, B. M., & Giang, M. T. (2021). Internet use and psychological well-being among adolescents. Journal of Youth and Adolescence, 50(5), 1012–1028.
23. Wei, Y., McGrath, P. J., Hayden, J., & Kutcher, S. (2015). Mental health literacy measures evaluating knowledge, attitudes and help-seeking: A scoping review. BMC Psychiatry, 15, 291. https://doi.org/10.1186/s12888-015-0681-9
24. Evins, Kennedy, “Future Parents: Associations between social media use, parenting styles, and parenthood desires” (2022). Honors Theses. 853. https://aquila.usm.edu/honors_theses/853
25. Pego Pérez, E. R., Bermello López, M. L., Gómez Fernández, E., Marín Arnés, M. d. R., Fernández Vázquez, M., Núñez Hernández, M. I., & Gutiérrez García, E. (2025). Predicting Quality of Life in Relapsing–Remitting Multiple Sclerosis: Clinical Burden Meets Emotional Balance in Early Disease. Neurology International, 17(12), 195. https://doi.org/10.3390/neurolint171201
26. Sansome, K., Conduit, J. & Wilkie, D. Acknowledging brand shortcomings: the interplay between negative disclosures, brand transparency, brand credibility, and word-of-mouth. J Brand Manag (2025). https://doi.org/10.1057/s41262-025-00412-0
27. Blok, E., Koopman-Verhoeff, M.E., Dickstein, D.P. et al. Sleep and mental health in childhood: a multi-method study in the general pediatric population. Child Adolesc Psychiatry Ment Health 16, 11 (2022). https://doi.org/10.1186/s13034-022-00447-0
28. Wenger, E. Communities of Practice: Learning, Meaning, and Identity; Cambridge University Press: Cambridge, UK, 1988. 
29. Antwi, S. K., & Hamza, K. (2015). Qualitative and quantitative research paradigms in business research: A philosophical reflection. European journal of business and management, 7(3), 217-225
30. Zhang, X., Liu, S., Chen, X., Wang, L., Gao, B., & Zhu, Q. (2018). Health information privacy concerns, antecedents, and information disclosure intention in online health communities. Information & Management, 55(4), 482-493.