Mental health and suicide literacy among school nurses in Japan: A cross-sectional study

AI Summary

SNs in Japan demonstrate insufficient mental health and suicide literacy, limiting effective adolescent mental health support.
One third of SNs incorrectly believed psychotic symptoms can be managed by careful listening alone.
Many SNs hesitate to ask about suicide and over half lack confidence delivering mental health education; evidence-based training is essential.

PLoS One. 2026 Jun 5;21(6):e0334488. doi: 10.1371/journal.pone.0334488. eCollection 2026.

ABSTRACT

BACKGROUND: School nurses (SN) are key providers of school health services and play a vital role in promoting adolescent mental health and preventing suicide. However, research into their mental health literacy (MHL) and suicide literacy remains limited.

METHODS: A self-administered questionnaire survey was conducted with 337 SN from Japanese middle and high schools. The survey assessed SNs’ MHL and suicide literacy, including knowledge, attitudes, intended approaches, and confidence in addressing student mental health and suicide risks.

RESULTS: One-third of SN incorrectly believed that they could manage psychotic symptoms by careful listening alone. Many hesitated to ask students about suicide plans, even when risk was evident. Over half lacked confidence in providing mental health education.

CONCLUSION: SNs’ MHL and suicide literacy are currently insufficient in Japan. Developing evidence-based training to improve these competencies is essential to strengthen school health services and promote better adolescent mental health and lower suicide risk.

PMID:42247434 | DOI:10.1371/journal.pone.0334488

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