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Mental health literacy (MHL) is vital for raising mental health awareness, reducing stigma, and improving health-related decision making, which may have lifelong consequences for patients with mental disorders. To examine MHL about depression among rural left-behind children (LBC) in China and explore differences between LBC and non-left-behind children (NLBC). A total of 3456 rural school children (mean age = 13.02 years) in fourth to ninth grades who were living in Sichuan, Anhui, and Henan provinces were surveyed in April and