Analysis of influencing factors and urban-rural difference decomposition of mental health literacy among residents in Chongqing, Southwest China: a large-scale multistage random sampling survey.

Background: Mental health literacy (MHL), as a core issue in public health, is closely associated with population mental health status and the ability to cope with psychological problems. This study aimed to evaluate the level of MHL among residents in Chongqing, identify its influencing factors, and explore the sources of urban-rural differences in MHL. Methods: A stratified multistage random sampling method was used to conduct a questionnaire survey among 36,874 permanent residents in Chongqing in 2025. The National Mental Health Literacy Questionnaire (NMHLQ) was used to assess MHL attainment. Results: The overall MHL attainment rate among residents was 32.21%, with urban residents showing a higher rate than rural residents (37.08% vs. 30.26%, Conclusion: The MHL attainment rate among residents in Chongqing was at a moderately high level; however, significant urban-rural disparities remained. Occupation, education level, and household economic conditions were the main sources of these differences. Greater attention should be paid to rural residents and populations with low education levels, low income, and poor health status. It is recommended to integrate primary healthcare, community education, and digital communication resources to promote equitable improvement in MHL.