Provider and patient perception of psychiatry patient health literacy

Main Article Content


Health Literacy, Health Knowledge, Attitudes, Practice, Perception, Mental Disorders, Health Personnel, Surveys and Questionnaires, United States


Background: Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations.

Objective: The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers’ perception of patients’ health literacy.

Methods: We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS). Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared.

Results: Inadequate health literacy was identified in 31 out of 61 patients (50.8%) using 2 questions from the BHLS. Only 9 (29%) of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy.

Conclusions: These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.

Abstract 2277 | PDF Downloads 1013 Appendix 1 Downloads 247


1. Ratzan SC, Parker RM.Introduction. In: National Library of Medicine Current Bibliographies in Medicine: Health Literacy . Selden CR, Zorn M, Ratzan SC, Parker RM, eds. Bethesda, MD: NIH; 2000.

2. Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA. 1999 Feb 10;281(6):552-57.

3. OECD (2016), Skills matter: further results from the survey of adult skills. Paris (acessed 20-Dec-2016).

4. Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. J Gen Intern Med. 2005;20(2):175-184. doi:10.1111/j.1525-1497.2005.40245.x

5. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Viera A, Crotty K, Holland A, Brasure M, Lohr KN, Harden E, Tant E, Wallace I VM. Health literacy interventions and outcomes: an updated systematic review. Evid Rep Technol Assess (Full Rep). 2011;(199):1-941.

6. Baker DW, Wolf MS, Feinglass J, Thompson JA, Gazmararian JA, Huang J. Health literacy and mortality among elderly persons. Arch Intern Med. 2007 Jul 23;167(14):1503-1509. doi: 10.1001/archinte.167.14.1503

7. McNaughton CD, Cawthon C, Kripalani S, Liu D, Storrow AB, Roumie CL. Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure. J Am Heart Assoc. 2015;4(5). doi: 10.1161/JAHA.115.001799

8. Wei Y, McGrath PJ, Hayden J, Kutcher S. Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC Psychiatry. 2015;15(1):291. doi: 10.1186/s12888-015-0681-9

9. Sheridan SL, Halpern DJ, Viera AJ, Berkman ND, Donahue KE, Crotty K. Interventions for Individuals with Low Health Literacy: A Systematic Review. J Health Commun. 2011;16(suppl3):30-54. doi: 10.1080/10810730.2011.604391

10. Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33-42. doi: 10.1016/S0738-3991(98)00116-5

11. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995;10(10):537-541.

12. Chew LD, Bradley KA, Boyko E. Brief questions to identify patients with inadequate health literacy. Fam Med. 2004;36(8):588-594.

13. McNaughton C, Wallston KA, Rothman RL, Marcovitz DE, Storrow AB. Short, subjective measures of numeracy and general health literacy in an adult emergency department. Acad Emerg Med. 2011;18(11):1148-1155. doi: 10.1111/j.1553-2712.2011.01210.x

14. Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, Vanryn M. Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008;23(5):561-566. doi: 10.1007/s11606-008-0520-5

15. Cavanaugh KL, Osborn CY, Tentori F, Rothman RL, Ikizler TA, Wallston KA. Performance of a brief survey to assess health literacy in patients receiving hemodialysis. Clin Kidney J. 2015;8(4):462-468. doi: 10.1093/ckj/sfv037

16. Peterson PN, Shetterly SM, Clarke CL, Bekelman DB, Chan PS, Allen LA, Matlock DD, Magid DJ, Masoudi FA. Health literacy and outcomes among patients with heart failure. JAMA. 2011;305(16):1695-1701. doi: 10.1001/jama.2011.512

17. McNaughton CD, Kripalani S, Cawthon C, Mion LC, Wallston KA, Roumie CL. Association of health literacy with elevated blood pressure: a cohort study of hospitalized patients. Med Care. 2014;52(4):346-353. doi: 10.1097/MLR.0000000000000101

18. Sarkar U, Schillinger D, López A, Sudore R. Validation of self-reported health literacy questions among diverse english and spanish-speaking populations. J Gen Intern Med. 2011;26(3):265-271. doi: 10.1007/s11606-010-1552-1

19. Louis AJ, Arora VM, Matthiesen MI, Meltzer DO, Press VG. Screening hospitalized patients for low health literacy: beyond the REALM of possibility? Health Educ Behav. 2017;44(3):360-364. doi: 10.1177/1090198116661478

20. Goodman MS, Griffey RT, Carpenter CR, Blanchard M, Kaphingst KA. Do subjective measures improve the ability to identify limited health literacy in a clinical setting? J Am Board Fam Med. 2015;28(5):584-594. doi: 10.3122/jabfm.2015.05.150037

21. Galletly C, Neaves A, Burton C, Liu D, Denson LA. Evaluating health literacy in people with mental illness using the Test of Functional Health Literacy in Adults. Nurs Outlook. 2012;60(5):316-321. doi: 10.1016/j.outlook.2012.01.003

22. Bass PF, Wilson JF, Griffith CH, Barnett DR. Residents’ ability to identify patients with poor literacy skills. Acad Med. 2002;77(10):1039-1041. doi: 10.1097/00001888-200210000-00021

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>