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Northeastern Professor Studies Limited Literacy and Mental Health Outcomes

December 1, 2008 – Alisa Lincoln, Ph.D., M.P.H., associate professor of health sciences and sociology at Northeastern, recently completed one of the first studies of its kind on the role of literacy and mental health. While much attention has been focused on the role of literacy and health, little is known about the relationship between literacy and mental health. This study was designed to assess the literacy level of people seeking treatment for a full range of psychiatric disorders with the hopes of better understanding the relationship between literacy and mental health outcomes.

The results were published in the Journal of Nervous and Mental Disease.

According to the National Institutes of Health, an estimated 26.2 percent of Americans ages 18 and older — about one in four adultssuffer from a diagnosable mental disorder in a given year. In addition, millions of Americans lack the literacy proficiency necessary to understand and act on health information from health care providers.

“Although mental health issues and limited literacy are very common in the United States, there is little information about how one impacts the other,” said Lincoln.

Literacy impacts health outcomes, and limited literacy creates unique challenges in mental health treatment. Current standard psychiatric evaluations do not include a literacy assessment, and many treatment methods assume a certain level of literacy, creating barriers to positive health outcomes for patients with a psychiatric diagnosis.

Professor Lincoln and her colleagues conducted this study in an urban public health clinic with patients diagnosed with a wide range of psychiatric diagnoses, including depression, bipolar disorder, anxiety, substance abuse, attention deficit hyperactivity disorder and schizophrenia.

“Most of the current information about mental health and literacy focuses only on depression,” said Lincoln. “We wanted to expand on that and look at other diagnoses to examine how literacy levels vary among different diagnoses.”

This study was done in collaboration with Dr. Peggy Johnson, Vice Chair of Clinical Psychiatry at Boston Medical Center.

The data collected showed that a complicated relationship exists between literacy and the aforementioned psychiatric diagnoses. There exists a correlation between limited literacy in some diagnoses, but it was not consistent.

“In order to develop effective psychiatric treatments that result in better outcomes, we need to increase our understanding of the relationships that exist between psychiatric disorders – on all levels – and health literacy,” added Lincoln. “It is important for clinicians to take literacy levels into consideration when developing treatment plans for their patients.”

For more information about Professor Lincoln’s research, please visit or contact Jenny Eriksen at (617) 373-2802 or via email at

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