Construct validity and internal consistency of the revised Mental Health Literacy Scale in South African and Zambian contexts.
Joonas Korhonen, Anna Axelin, Jouko Katajisto and 1 others
PMID 34822738WHAT IT FOUND
The revised Mental Health Literacy Scale works well as a single score for primary care workers in South Africa and Zambia, but its sub-scores for knowledge are unreliable.
Use the total score to assess overall literacy, but do not trust the separate knowledge breakdowns.
Key findings
01The total scale showed strong internal consistency, supporting its use as a single measure of mental health literacy.
02Three of the six specific knowledge and self-treatment sub-scales failed to meet the acceptable level for internal consistency.
03The scale's nine principal components explained approximately 59% of the total variance and aligned with the theoretical structure.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used convenience sampling, which may not represent all primary care workers in the region. Data collection occurred in hectic clinic environments, which the authors suggest may have affected the precision of participants' responses. There is no 'gold standard' for mental health literacy instruments, so the scale could not be compared against an established benchmark. The poor internal consistency of three sub-scales means the instrument cannot reliably measure specific knowledge domains separately.
Declared interests
The study was funded by the European Union as part of the MEGA project. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume the Mental Health Literacy Scale can reliably measure specific types of knowledge, such as understanding risk factors or how to seek professional help. While the total score is consistent, the sub-scores for these knowledge areas failed to meet standard reliability thresholds, meaning low scores in these specific domains may reflect measurement error rather than actual gaps in a clinician's knowledge.