Clinical Correlates of Health Literacy in People with Serious Mental Illness

People with serious mental illness (SMI) experience health disparities (De Hert et al., 2011). Low health literacy could be an important factor for health outcomes in the SMI population (Krishan, von Esenwein, & Druss, 2012). The association between demographic and clinical variables was examined in people with SMI as possible predictors of health literacy. Participants were recruited via paper and electronic advertisements to assess health behaviors in adults with SMI and/or a diagnosis of type 2 diabetes. Participants completed a battery of tests including the Test of Functional Health Literacy in Adults (TOFHLA) to assess health literacy, the Positive and Negative Symptom Scale (PANSS) to assess positive and negative psychiatric symptoms, and the Dementia Rating Scale (DRS) to assess cognition. Data for adults with SMI only were analyzed using SPSS version 23. Participants (N = 56) were predominantly Caucasian (n = 48; 85.7%), female (n = 34; 61.8%), and lived alone (n = 26; 47.3%) or with someone else (n = 26; 47.3%). Overall, the sample had high total health literacy (M = 84.54; SD = 10.97). Total DRS scores correlated with total health literacy (r = .428; p = .001), as did living situation (r = .270; p = .047). The PANSS positive scores weakly correlated with reading health literacy (r = -.262; p = .051). The results vary by TOFHLA subscale. Three multiple linear regression models were created using data- and theory-driven variables to determine the strongest predictor of health literacy in this population. Understanding the relationship between cognition and health literacy in people with SMI could help providers improve health disparities that this population experiences.