A modified version of the mental health literacy scale (MHLS) in Iranian people

Abstract

Background The risk rate for the lifetime prevalence of any mental disorder is calculated as 50%, and the prevalence of mental disorders has an increasing trend. So, this study aimed to evaluate the Mental Health Literacy Scale (MHLS) among Iranian people. Methods This cross-sectional study was conducted with a multi-stage sampling method with 1273 people in the general population. After searching and reviewing various sources, the research team decided to use the questionnaire of MHLS with 35 items and six attributes that were measured and developed by O’Connor et al. The face, content, and construct validity (Confirmatory factor analysis) were used for validation of MHLS. McDonald’s omega coefficient and Cronbach’s alpha coefficient were used to calculate the reliability of MHLS. Confirmatory factor analysis was performed using AMOS software Version 24. Results In the CFA test, the six items were deleted. The final modified version of the MHLS included a total of 29 items with six attributes consisted of (a) knowledge of where to seek information (4 items), (b) ability to recognize disorders (8 items), (c) knowledge of self-treatment (2 items), (d) knowledge of risk factors and causes (2 items), (e) attitudes that promote recognition or appropriate help-seeking behavior (10 items), and (f) knowledge of professional help available (3 items). Based on the results of reliability, McDonald’s omega coefficient and Cronbach’s alpha coefficient for all attributes of MHLS were 0.797 and 0.789, respectively. Conclusion Due to the lack of appropriate instruments for measuring mental health literacy in the Iranian population, the modified version of MHLS with 29 items and six attributes can be considered as a valid and reliable instrument for this purpose.

Mental Health Literacy in Iranian Adolescents

“…The mean score of mental health literacy of the participants was 98.63±11.29 (35-160). Mean and standard deviation of scores for the ability to recognize certain disorders, knowledge of self-help interventions, knowledge of accessible professional help, and knowledge of searching for mental health-related information were 27.57±4.79 (10-40), 5.26±1.05 (2-8), 8.33±1.37 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12), and 14.3±2.98 (4-20), respectively. Furthermore, the mean of scores concerning knowledge of the risk factors and causes of mental disorders and an attitude facilitating recognition, were 29.48±4.89 (9-45) and 14.08±5.99 .…”

“…This study employed the previously validated Persian version of the Mental Health Literacy Scale (MHLS) 12 . This scale is a 35-item questionnaire developed by O'Connor, and approved in terms of validity and reliability 13,14 .…”

Validation and Psychometric Testing of the Chinese Version of the Mental Health Literacy Scale Among Nurses

“…At the item level, three items were deleted for poor item information: I-10 "men are more likely to experience an anxiety disorder compared to women, " I-15 "a mental health professional can break confidentiality if your problem is not life-threatening and they want to assist others to better support you, " I-20 "People with a mental illness could snap out if it if they wanted, " I-21 "A mental illness is a sign of personal weakness, " I-22 "A mental illness is not a real medical illness" and I-23 "People with a mental illness are dangerous." In the Iranian version,six questions (20,21,22,26,27,28) were deleted by CFA (Nejatian et al, 2021), while in the Persian version, five items (10,12,20,21,22) were deleted from item analysis (Heizomi et al, 2020). We could see that I-10, I-20, I-21, and I-22 generally had poor item information in various versions.…”

“…Among those scales, the Mental Health Literacy Scale (MHLS) poses rigid Consensus based standards for the selection of health Instruments (COSMIN) methodological quality and can be applied to general people judged by its item content (Mokkink et al, 2010), whereas the other scales mentioned above were for public housing staff, young people, or healthcare students. Therefore, once developed, MHLS has been rapidly used, and until now, it has been validated in Persian (Heizomi et al, 2020) and Iranian (Nejatian et al, 2021) versions among the general population. Additionally, content validation by expert panels has been conducted for primary health care workers in South Africa and Zambia (Korhonen et al, 2019).…”

“…The existing versions of the MHLS suggest that a different structure and possible item redundancy may emerge in a Chinese context. Because MHLS were found to have six factors in the Iranian version, five factors in the Persian version, and one factor in Chinese version among teachers, and these different versions deleted different items which were highly culture and context sensitive (Heizomi et al, 2020;Chen et al, 2021;Nejatian et al, 2021). Therefore, the purpose of this study was to psychometrically test the Chinese version of the Mental Health Literacy Scale (MHLS-C) and to document the level and influential factors of MHL among nurses.…”