Reliability and Validity of the Mental Health Quotient (MHQ)

Abstract

Background: The MHQ is an assessment of mental health and wellbeing that comprehensively covers symptoms across 10 major psychiatric disorders as defined by the DSM-5, in addition to constructs defined by RDoC and positive dimensions of mental function using a novel life-impact scale. An overall measure of mental wellbeing, the Mental Health Quotient or MHQ, is computed based on these elements using a nonlinear transformation of the scale followed by a rescaling. The MHQ has been deployed as part of the Mental Health Million Project as a freely available anonymous online assessment that, on completion, provides a score to the individual that places them on a spectrum from Distressed to Thriving along with a personal report spanning their various dimensions of mental wellbeing with strategies for improvement. Since its launch in April 2020 over 200,000 people have taken the MHQ. Here we provide various demonstrations of the reliability and validity of the MHQ.Objective: This paper outlines the reliability and validity of the Mental Health Quotient (MHQ), including construct validity of the life impact scale, sample and test-retest reliability of the assessment and criterion validation of the MHQ with respect to productivity loss and clinical burden.Methods: To assess sample reliability, random demographically matched samples of 11,033 people were compared from within the same 6-month period. Test retest reliability was determined using the subset of individuals who had taken the assessment twice at least 3 days apart (N=1907). In addition, a subset of respondents (N=4,247 or 7,625) were asked additional questions (along with the standard MHQ questions) on symptom frequency and severity for an example symptom (Feelings of Sadness, Distress or Hopelessness), days of work missed in the past month, and days with reduced productivity. In addition, elements with high negative life impact considered to meet the threshold to be considered a ‘symptom’ were mapped to the criteria for each of 10 major DSM-5 based mental health disorders to calculate the clinical burden (N=174,618).Results: Distinct samples collected during the same period had indistinguishable MHQ distributions and average ratings for each of the 47 elements, demonstrating the reliability of the assessment and MHQ scores were correlated with r=0.84 between retakes. The life impact rating was correlated with both frequency and severity of symptoms and mean values had a clear linear relationship with an R2>0.99. Furthermore, aggregate MHQ scores were systematically related to both productivity and clinical burden. At one end of the scale, those in the Distressed category had an average productivity loss of 15.2±0.5 days per month with 89.08% (8,986/10,087) mapping to 1 or more DSM-5 based clinical disorders. In contrast those at the other end of the scale, in the Thriving category, had an average productivity loss of 1.3±0.1 and 0.00% (1/24,365) had any DSM-5 based clinical disorder.Conclusions: The MHQ is a valid and reliable assessment of mental wellbeing when delivered anonymously online

Hierarchy of Demographic and Social Determinants of Mental Health

“…While all demographic factors together were effective at predicting MHQ sign, young age (i.e., being 18-24 followed by 25-34) was disproportionately powerful as a predictor of negative mental health. This is supported by other evidence that shows overall mental health status is worse for each younger age group: data from the Mental Health Million Project has shown that in 2021, 44% of young adults (18-24 years) were mentally distressed or struggling compared to 7% among those aged 65 and above [72], while other studies also highlight the increase in mental health problems in teens [2] [3]. This is in sharp contrast to psychological wellbeing patterns observed prior to 2010 where young adults were typically at the higher end of wellbeing scales [86] [87].…”

“…This includes demonstration that, in the aggregate, average number of clinical symptoms and clinical diagnoses increase systematically as MHQ scores decrease, and that MHQ scores are linearly related to work productivity, including absenteeism and presenteeism [69]. Population MHQ scores also align with well-established trends relating to age, employment, education, physical exercise, sleep and social engagement, as well as being generally higher in males than females [72].…”

“Art and Psyche Festival”: Utilizing the power of art against the stigma around mental illness

“…The results of the Mental Health Million project, which is a survey on global mental wellbeing launched by Sapien Labs, revealed that in 2021, more than 50% of people with clinical mental health risks did not seek psychological help. It also stated that 25% of those not seeking help cited stigma as the leading cause ( 8 ).…”