Abstract: Background Mental health literacy (MHL) is a critical determinant in addressing the gap between mental health service needs and utilization. Among ethnic minorities in rural frontier regions, MHL not only affects individual psychological well-being but also has implications for social cohesion and health equity. However, evidence on MHL and its associated factors among residents of rural ethnic minority areas in border regions remains notably scarce. Objective To assess MHL and identify its influencing factors among three ethnic minorities residing in Yunnan Province for generations, and to provide an evidence base for the development of targeted mental health promotion policies. Methods A cross-sectional survey was conducted from March to July 2022 among 1 650 residents from six townships in four ethnically diverse counties in Yunnan. Data were collected using a structured questionnaire covering demographic characteristics, health status, health behaviors, MHL [assessed using the National Mental Health Literacy Questionnaire (NMHLQ)], depressive symptoms [measured by the Patient Health Questionnaire-9 (PHQ-9)], anxiety symptoms [measured by the Generalized Anxiety Disorder-7 (GAD-7)], and insomnia severity [assessed with the Insomnia Severity Index (ISI)]. Multivariable Logistic regression was used to identify factors associated with MHL. Results A total of 1 565 valid questionnaires were included (effective rate was 94.85%). The overall rate of MHL adequacy was critically low (3.4%), with significant disparities among the Bai (3.8%), Dai (4.5%), and Derung (1.3%) groups. The Derung ethnicity was independently associated with lower MHL adequacy compared to the other two groups. Gender, individual monthly income, residence location, and self-rated health status were also significant influencing factors (P<0.05). Conclusion The notably low level of mental health literacy among the Bai, Dai, and Derung ethnic groups in Yunnan underscores an urgent need for targeted mental health literacy promotion initiatives in rural ethnic minority regions of the border areas. This should include the development and translation of mental health education materials into local ethnic languages, as well as the adoption of culturally and socioeconomically appropriate communication approaches. A systematic strategy is required to comprehensively enhance mental health awareness, knowledge, skills, and coping capacities among these populations.

Key words: Mental health, Health literacy, Rural health, Minority health, Yunnan

摘要： 背景 心理健康素养是弥合心理健康服务需求与利用差距、促进全民心理健康的核心和关键。边疆农村少数民族群体心理健康素养不仅影响其心理健康状况，而且关乎社会和谐与健康公平。既有研究对多元文化交融社会背景中边疆农村少数民族心理健康素养关注不够。目的 探讨云南省白族、傣族、独龙族三个世居少数民族的心理健康素养及影响因素，为研制有针对性的心理健康促进方案和政策提供基础信息和决策依据。方法 于2022年3—7月，采用多阶段分层随机抽样法在云南省4个少数民族聚居县（市）的6个乡镇中抽取1 650名少数民族居民进行问卷调查，内容包括居民的基本特征、健康行为、健康状况、心理健康素养［采用国民心理健康素养问卷（NMHLQ）评估］、抑郁症状［采用患者健康问卷（PHQ-9）评估］、焦虑症状［采用广泛性焦虑量表（GAD-7）评估］、失眠严重程度［采用失眠严重程度量表（ISI）评估］。采用多元 Logistic 回归分析居民心理健康素养的影响因素。结果 最终获得有效问卷1 565份，问卷有效率为94.8%。三个世居少数民族居民的心理健康素养达标率为3.4%（53/1 565），其中白族3.8%（18/471）、傣族4.5%（29/638）、独龙族1.3%（6/456），独龙族居民心理健康素养达标率低于白族和傣族居民（P<0.017）。多元Logistic回归分析结果显示，性别、居住地区、个人月收入、自评健康状况是居民心理健康素养的影响因素（P<0.05）。结论 云南省白族、傣族和独龙族居民的心理健康素养水平极低，亟须在边疆农村民族地区开展心理健康素养专项促进行动，开发与翻译民族语言版本的心理健康宣教材料，采用与少数民族社会经济文化适配的宣教方式，以系统性策略全方位提升心理健康意识、知识、技能及应对能力。

关键词: 精神卫生, 健康素养, 农村卫生, 少数民族卫生, 云南