AN EXAMINATION OF MENTAL HEALTH LITERACY AND STIGMA AGAINST MENTAL ILLNESS USING AN ITEM RESPONSE THEORY APPROACH

Abstract

Mental illness is a leading cause of disease burden for college age individuals and impacts an estimated 43 million Americans annually. The individual burden of mental illness causes high physical morbidity and mortality that leads to a dramatically shortened lifespan. Mental illness is highly treatable, and early intervention leads to an improved long-term outcome. Regardless of level of disability, people displaying symptoms of mental illness are more harshly stigmatized than those with other non-mental health ailments. The latter stigmatization results in years long delay in mental health help-seeking. Existing evidence indicates that health literacy is vital to maintaining good physical health. However, the knowledge and skills that facilitate one’s ability to prevent, recognize, and manage mental health related issues has not been incorporated into traditional definitions of health literacy. Mental health literacy programming has been hypothesized to improve delays in mental health help-seeking through improved knowledge and awareness that results in reduced stigma against mental illness. The evidence base supporting this hypothesis is lacking mainly due to the need for theory-based psychometrically sound instruments that allow for reliable and valid measurement of mental health literacy. The appropriate assessment of mental health literacy is critical to reducing the burden of mental illness stigma. Thus, this study uses advanced statistical and psychometric analyses, including item response theory, to examine items of a recently developed scale purporting to measure mental health literacy. Major scale revisions are elucidated, and using theory-based test construction practices, a new mental health literacy scale is proposed. The psychometric properties of the new scale are discussed, as is the extent to which mental health literacy is related to enacted mental illness stigma. The use of the new mental health literacy scale as part of evidenced-based interventions to improve mental health literacy should help lessen the burden of stigma against people with mental health problems.