Reliability and validity of the Japanese version of the Mental Health Literacy Scale (MHLS) among undergraduate and graduate students in the medical field

ObjectiveMental health literacy (MHL) is a fundamental basis of reducing stigma towards mental disorders and promoting early help-seeking. However, there is no internationally standardized scale covering all the attributes of MHL available in Japan. This study aimed to examine the reliability and validity of the Japanese version of the Mental Health Literacy Scale (MHLS) developed by OConnor et al. (2015). MethodsThe MHLS was translated in accordance with international guidelines. Japanese students in the medical field were invited to complete an online questionnaire twice at baseline and two-week follow-up. Using the data, Cronbachs alphas, intra-class correlation coefficient (ICC), and measurement errors were calculated for internal consistency and test-retest reliability. Correlations with mental health-related behavior (RIBS), accurate knowledge about mental disorders (MIDUS), intentions to seek help (GHSQ), and psychological distress (K6) were used to examine the convergent validity. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed to test structural validity. ResultsA total of 183 and 150 students responded at baseline and follow-up. Cronbachs alpha coefficient was 0.76 and the ICC was 0.77 for the total score. The MHLS had a strong positive correlation with RIBS and moderate positive correlations with MIDUS and GHSQ. The CFA did not show a good fit either for one-or six-factor models, and the EFA yielded a four-factor structure. ConclusionsThe Japanese version of the MHLS demonstrated adequate reliability and validity, while the factor structure did not fit previously proposed models. This scale may be useful for assessing the degree of MHL among medical field students in Japan.