Assessing knowledge and attitudes about mental illness in Ningxia, China

Abstract

To assess the effectiveness of China's recent moves to increase community mental health literacy and decrease stigma, we developed the Mental Health Knowledge Questionnaire (MHKQ) and the Mental Health Attitude Questionnaire (MHAQ). Preliminary versions were assessed in pilot studies and revised versions were included in an interviewer-administered community survey of a representative sample of 2425 adult residents of Ningxia Province and a re-test survey in 188 individuals. Internal consistency, factor structure and test-retest reliability were assessed for three measures: (a) the 25-item MHKQ (alpha = .71, 6 factors accounting for 51% of variance identified in exploratory factor analysis of one-half of the sample, and intraclass correlation coefficient [ICC] for total score of .40); (b) the 14-item attitudinal subscale of MHAQ (alpha = .69, 3 factors accounting for 42% of variance, ICC = .47); and (c) the 7-item causal attribution subscale of MHAQ (alpha = .60, 3 factors accounting for 60% of variance, ICC = .26). Confirmatory factor analysis assessed fitness of modified models of the measures using chi-squared, comparative fit index (CFI), Tucker-Lewis index (TLI), and root mean square error of approximation (RMSEA): (a) for the MHKQ, RMSEA = .037 (90% CFI = .033, .040), CFI = .86, TLI = .84, χ = 682.86 (df = 260); (b) for the attitudinal subscale of MHAQ, RMSEA = .045 (CI = .039, .052), CFI = .94, TLI = .92, χ = 226.67 ( df = 66); and (c) for the causal attribution subscale of MHAQ, RMSEA = .054 (.039, .069), CFI = .97, TLI = .94, χ = 49.13 ( df = 11). We conclude that the internal consistency and factor structure of the new measures are satisfactory, but further work is needed to improve the scales' stability and to assess the construct validity and responsiveness of the scales.

Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study

“…First, the MHK questionnaire was developed by the Chinese MOH for use in China specifically, limiting generalizability of the findings to other regions of the world. However, several well-known aspects of MHK [30] were included in the MHK questionnaire and several items were quite similar to those used in other developed scales [31][32][33] and used in other studies [34,35]. Second, the generalizability of the findings to all of China may be limited due to large regional differences.…”

Mental health knowledge and awareness among university students in Bangladesh

“…We have also used Goldberg's GHQ-12 (General Health Questionnaire) questionnaire items for assessing participants' mental health conditions [ 33 , 34 ]. From earlier studies [ 21 , 35 , 36 , 37 , 38 ], twenty-four questions for assessing mental health knowledge and twelve questions for testing mental health awareness and seven questions for measuring belief towards mental health were employed. We collected the questionnaire items from those studies and validated the correct answers by checking them.…”

Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness

“…We use data from a comprehensive mental health knowledge and attitude survey (which included the IDS and ORS) conducted in Ningxia autonomous region, a province in northwestern China with a population of 6.5 million. The sampling and survey administration procedures have been described in previous publications by our research group (Chen, Wang, & Phillips, 2018;Chen, Wang, Phillips, Sun, & Cheng, 2014;Cheng, Phillips, Zhang, & Wang, 2016). In brief, a probability proportionate to size method was used to identify a representative sample of 2425 noninstitutionalized adult residents (⩾18 years old) from 20 primary sampling sites around the province who participated in face-to-face structured interviews in their homes conducted by trained interviewers.…”