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

Objective: To determine mental health literacy levels and their predictors among primary health care workers across Nigeria's five geopolitical zones, and to identify common patient presentations and rates of suspected psychological illness. Design: A cross-sectional, mixed-methods study using a census method. Setting: The National Refresher Course Centre of the National Association of Community Health Practitioners of Nigeria, held at Wesley University, Ondo State. Participants: 66 members of the National Association of Community Health Practitioners of Nigeria. Interventions: A semi-structured questionnaire to collect socio-demographic data and Focus Group Discussions were also conducted among Community Health Practitioners in each zone. Main outcome measures: Mental health literacy and the predictors. Results: Mental health literacy among primary health care workers was low, with only 12.1% demonstrating above-average knowledge, mainly associated with longer work experience and a family history of mental illness. Patients commonly presented with physical complaints and symptoms such as fever, headache, insomnia, weight loss, and weakness, while underlying mental health conditions like anxiety, depression, and substance use disorders were often unrecognised. Routine mental health assessment was rare, and referrals to psychiatric services were infrequent, with most workers reporting only two to three referrals in the past year. Conclusion: The mental health literacy of primary health care workers in Nigeria is critically low, highlighting an urgent need for extensive capacity building to improve the detection of psychological illness for comprehensive healthcare delivery. Funding: None declared.