MENTAL HEALTH LITERACY AND STIGMA QUESTIONNAIRE: A VALIDATION STUDY AMONG YOUNG ADULTS

Authors

DOI:

https://doi.org/10.55197/qjssh.v7i3.1227

Keywords:

mental health literacy, stigma, help-seeking, reliability

Abstract

This study aimed to validate the Mental Health Literacy and Stigma Questionnaire among young adults residing in Kuala Lumpur and Selangor. Although other instruments assessing knowledge, attitudes, and help-seeking domains have been validated, there is currently no published validation study of this specific questionnaire targeting early adulthood in the Malaysian context. A purposive sampling method was employed using online recruitment. A total of 289 participants completed the online survey, with a mean age of 20.82 years. Confirmatory Factor Analysis was conducted on eight latent constructs. The final 58-item model demonstrated an acceptable fit based on relative chi-square and Root Mean Square Error of Approximation indices. Convergent validity was established for five constructs: Knowledge about Prevention, Help-Seeking, Perceived Self-Stigma, Perceived Community Stigma, and Social Distance. Most constructs also demonstrated discriminant validity. Furthermore, high composite reliability values were observed for Knowledge about Illness, Knowledge about Prevention, Help-Seeking, Perceived Self-Stigma, Perceived Community Stigma, and Social Distance. This study contributes to the field by offering a preliminary validation of a culturally relevant tool for assessing mental health literacy and stigma among Malaysian youth.

References

[1] Abolfotouh, M.A., Almutairi, A.F., Almutairi, Z., Salam, M., Alhashem, A., Adlan, A.A., Modayfer, O. (2019): Attitudes toward mental illness, mentally ill persons, and help-seeking among the Saudi public and sociodemographic correlates. – Psychology Research and Behavior Management 12: 45-54.

[2] Almanasef, M. (2021): Mental health literacy and help-seeking behaviours among undergraduate pharmacy students in Abha, Saudi Arabia. – Risk Management and Healthcare Policy 14: 1281-1286.

[3] Awang, Z. (2012): A Handbook on SEM: Structural Equation Modelling Using AMOS Graphics. – Universiti Teknologi MARA Press, Kota Bharu 167p.

[4] Bollen, K.A. (1989): Structural Equations with Latent Variables. – Wiley, New York 528p.

[5] Brown, T.A. (2015): Confirmatory Factor Analysis for Applied Research. – The Guilford Press, New York 462p.

[6] Browne, M.W., Cudeck, R. (1993): Alternative ways of assessing model fit. – In: Bollen, K. A., Long, J. S. (eds.) Testing Structural Equation Models, Sage, Newbury Park 27p.

[7] Byrne, B.M. (2010): Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. 2nd Ed. – Routledge, New York 416p.

[8] Campos, L., Dias, P., Palha, F., Duarte, A., Veiga, E. (2016): Development and psychometric properties of a new questionnaire for assessing mental health literacy in young people. – Universitas Psychologica 15(2): 61-72.

[9] Cheung, G.W., Cooper-Thomas, H.D., Lau, R.S., Wang, L.C. (2024): Reporting reliability, convergent and discriminant validity with structural equation modeling: A review and best-practice recommendations. – Asia Pacific Journal of Management 41(2): 745-783.

[10] Coates, D., Saleeba, C., Howe, D. (2019): Mental health attitudes and beliefs in a community sample on the Central Coast in Australia: Barriers to help seeking. – Community Mental Health Journal 55(3): 476-486.

[11] Colman, A.M., Norris, C.E., Preston, C.C. (1997): Comparing rating scales of different lengths: Equivalence of scores from 5-point and 7-point scales. – Psychological Reports 80(2): 355-362.

[12] Dattani, S., Ritchie, H., Roser, M. (2021): Mental health. – Our World in Data 4p.

[13] Eigenhuis, E., Waumans, R.C., Muntingh, A.D.T., Westerman, M.J., van Meijel, M., Batelaan, N.M., van Balkom, A.J.L.M. (2021): Facilitating factors and barriers in help-seeking behaviour in adolescents and young adults with depressive symptoms: A qualitative study. – PLoS ONE 16(3): 20p.

[14] Evans-Lacko, S., Little, K., Meltzer, H., Rose, D., Rhydderch, D., Henderson, C., Thornicroft, G. (2010): Development and psychometric properties of the Mental Health Knowledge Schedule. – Canadian Journal of Psychiatry 55(7): 440-448.

[15] Fornell, C., Larcker, D.F. (1981): Evaluating structural equation models with unobservable variables and measurement error. – Journal of Marketing Research 18(1): 39-50.

[16] Griffiths, K.M., Christensen, H., Jorm, A.F. (2008): Predictors of depression stigma. – BMC Psychiatry 8: 12p.

[17] Guilford, J.P. (1954): Psychometric Methods. – McGraw-Hill, New York 597p.

[18] Hair, J.F., Black, W.C., Babin, B.J., Anderson, R.E. (2010): Multivariate Data Analysis: A Global Perspective. – Pearson Prentice Hall, Upper Saddle River 800p.

[19] Hair, J.F., Hult, G.T.M., Ringle, C.M., Sarstedt, M. (2016): A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). – Sage Publications, Thousand Oaks 384p.

[20] Hair, J.F., Howard, M.C., Nitzl, C. (2020): Assessing measurement model quality in PLS-SEM using confirmatory composite analysis. – Journal of Business Research 109: 101-110.

[21] Hernández-Torrano, D., Ibrayeva, L., Sparks, J., Lim, N., Clementi, A., Almukhambetova, A., Nurtayev, Y., Muratkyzy, A. (2020): Mental health and well-being of university students: A bibliometric mapping of the literature. – Frontiers in Psychology 11: 16p.

[22] Hu, L.T., Bentler, P.M. (1999): Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. – Structural Equation Modeling: A Multidisciplinary Journal 6(1): 55p.

[23] Jafari, A., Nejatian, M., Momeniyan, V., Barsalani, F.R., Tehrani, H. (2021): Mental health literacy and quality of life in Iran: A cross-sectional study. – BMC Psychiatry 21: 11p.

[24] Jones, P.B. (2013): Adult mental health disorders and their age at onset. – British Journal of Psychiatry 202(S54): S5-S10.

[25] Jorm, A.F. (2012): Mental health literacy: Empowering the community to take action for better mental health. – American Psychologist 67(3): 231-243.

[26] Jorm, A.F., Korten, A.E., Jacomb, P.A., Christensen, H., Rodgers, B., Pollitt, P. (1997): Mental health literacy: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. – Medical Journal of Australia 166(4): 182-186.

[27] Jung, H., Von Sternberg, K., Davis, K. (2016): Expanding a measure of mental health literacy: Development and validation of a multicomponent mental health literacy measure. – Psychiatry Research 243: 278-286.

[28] Kågström, A., Pešout, O., Kučera, M., Juríková, L., Winkler, P. (2023): Development and validation of a universal mental health literacy scale for adolescents (UMHL-A). – Psychiatry Research 320: 9p.

[29] Kotera, Y., Ting, S.H., Neary, S. (2021): Mental health of Malaysian university students: UK comparison, and relationship between negative mental health attitudes, self-compassion, and resilience. – Higher Education 81(2): 403-419.

[30] Kristina, S.A., Mardea, N.A., Ramadhani, F., Aliyah, H. (2020): Mental health literacy among university students in Yogyakarta. – International Medical Journal 25(4): 2243-2249.

[31] Krosnick, J.A. (1991): Response strategies for coping with the cognitive demands of attitude measures in surveys. – Applied Cognitive Psychology 5(3): 213-236.

[32] Kutcher, S., Wei, Y., Coniglio, C. (2016): Mental health literacy: Past, present, and future. – Canadian Journal of Psychiatry 61(3): 154-158.

[33] Loureiro, L.M., Jorm, A.F., Mendes, A.C., Santos, J.C., Ferreira, R.O., Pedreiro, A.T. (2013): Mental health literacy about depression: A survey of Portuguese youth. – BMC Psychiatry 13: 8p.

[34] Ministry of Health Malaysia (MOHM) (2020): National Health and Morbidity Survey 2019: Technical Report, Volume I-NCDs: Non-Communicable Diseases, Risk Factors and Other Health Problems. – Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur 392p.

[35] Ministry of Health Malaysia (MOHM) (2015): National Health and Morbidity Survey 2015. Volume II: Non-Communicable Diseases, Risk Factors and Other Health Problems. – Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur 315p.

[36] Mohamad, N.E., Sidik, S.M., Akhtari-Zavare, M., Gani, N.A. (2021): The prevalence risk of anxiety and its associated factors among university students in Malaysia: A national cross-sectional study. – BMC Public Health 21: 12p.

[37] Munawar, K., Mukhtar, F., Choudhry, F.R., Ng, A.L.O. (2022): Mental health literacy: A systematic review of knowledge and beliefs about mental disorders in Malaysia. – Asia-Pacific Psychiatry 14(1): 11p.

[38] Nguyen Thai, Q.C., Nguyen, T.H. (2018): Mental health literacy: Knowledge of depression among undergraduate students in Hanoi, Vietnam. – International Journal of Mental Health Systems 12: 8p.

[39] Nutbeam, D., Wise, M., Bauman, A., Harris, E., Leeder, S. (1993): Goals and Targets for Australia’s Health in the Year 2000 and Beyond. – Australian Government Publishing Service, Canberra 271p.

[40] O’Connor, M., Casey, L. (2015): The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. – Psychiatry Research 229(1-2): 511-516.

[41] O’Connor, M., Casey, L., Clough, B. (2014): Measuring mental health literacy: A review of scale-based measures. – Journal of Mental Health 23(4): 197-204.

[42] Pheh, K.S., Ooi, W.H., Low, S.K., Tan, C.S., Kok, J.K. (2017): The Malay version of the Mental Health Knowledge Schedule: A preliminary study. – Malaysian Journal of Psychiatry 26(1): 10-14.

[43] Reavley, N.J., Jorm, A.F. (2011a): Recognition of mental disorders and beliefs about treatment and outcome: Findings from an Australian national survey of mental health literacy and stigma. – Australian and New Zealand Journal of Psychiatry 45(11): 947-956.

[44] Reavley, N. J., Jorm, A. F. (2011b): Stigmatizing attitudes towards people with mental disorders: Findings from an Australian national survey of mental health literacy and stigma. – Australian and New Zealand Journal of Psychiatry 45(12): 1086-1093.

[45] Reavley, N.J., Jorm, A.F. (2011c): Young people’s recognition of mental disorders and beliefs about treatment and outcome: Findings from an Australian national survey. – Australian and New Zealand Journal of Psychiatry 45(10): 890-898.

[46] Shaughnessy, J.J., Zechmeister, E.B., Zechmeister, J.S. (2015): Research Methods in Psychology. – McGraw-Hill Education, New York 512p.

[47] Simkiss, N.J., Gray, N.S., Dunne, C., Snowden, R.J. (2021): Development and psychometric properties of the Knowledge and Attitudes to Mental Health Scales (KAMHS): A psychometric measure of mental health literacy in children and adolescents. – BMC Pediatrics 21: 10p.

[48] Singh, S., Zaki, R.A., Farid, N.D.N., Kaur, K. (2021): Validation and reliability of the Mental Health Literacy and Stigma Questionnaire among Malaysian young adolescents. – International Medical Research Journal 7(2): 14p.

[49] Spiker, D.A., Hammer, J.H. (2019): Mental health literacy as theory: Current challenges and future directions. – Journal of Mental Health 28(3): 238-242.

[50] Sweileh, W.M. (2021): Global research activity on mental health literacy. – Middle East Current Psychiatry 28: 9p.

[51] Taherdoost, H. (2019): What is the best response scale for survey and questionnaire design: Review of different lengths of rating scale, attitude scale and Likert scale. – International Journal of Academic Research in Management 8(1): 10p.

[52] Taherdoost, H. (2016): Validity and reliability of the research instrument: How to test the validation of a questionnaire/survey in a research. – International Journal of Academic Research in Management 5(3): 28-36.

[53] Venkataraman, S., Patil, R., Balasundaram, S. (2019): Why mental health literacy still matters: A review. – International Journal of Community Medicine and Public Health 6(6): 2723-2729.

[54] Wei, Y., McGrath, P.J., Hayden, J., Kutcher, S. (2016): Measurement properties of tools measuring mental health knowledge: A systematic review. – BMC Psychiatry 16: 16p.

[55] Wei, Y., McGrath, P.J., Hayden, J., Kutcher, S. (2015): Mental health literacy measures evaluating knowledge, attitudes and help-seeking: A scoping review. – BMC Psychiatry 15: 20p.

[56] Xia, Y., Yang, Y. (2019): RMSEA, CFI, and TLI in structural equation modeling with ordered categorical data: The story they tell depends on the estimation methods. – Behavior Research Methods 51(1): 409-428.

Downloads

Published

2026-06-30

Issue

Section

Articles

How to Cite

MENTAL HEALTH LITERACY AND STIGMA QUESTIONNAIRE: A VALIDATION STUDY AMONG YOUNG ADULTS. (2026). Quantum Journal of Social Sciences and Humanities, 7(3), 740-757. https://doi.org/10.55197/qjssh.v7i3.1227