Measuring Mental Health Provider-Based Stigma: Development and Initial Psychometric Testing of a Self-Assessment Instrument
- 793 Downloads
This article describes the development and initial psychometric testing of the Mental Health Provider Self-Assessment of Stigma Scale (MHPSASS), a 20-item instrument crafted in reflection of Charles’ (Social Work in Mental Health 11:360–375, 2013) empirically derived, experience-based, five-themed model of provider stigmatization. Following model and item review by construct experts, 220 mental health service providers in Virginia’s public mental health centers and in-patient facilities completed the survey package. Results indicate the refined MHPSASS is a reliable measure of provider-based stigma with promising face and content validity. However, rather than they hypothesized five-factors, analysis indicates a four-factor solution, a key finding signaling a discrepancy between what providers endorse and what clients’ experience. Notably absent from the MHPSASS’ were items related to blame and shame, in contrast to the experience of clients and families. Further refinement is indicated, particularly reconsideration of blame and shame items due to their practical and theoretical significance.
KeywordsStigma Mental illness Provider-based stigma Self-assessment of stigma Client experience
The authors would like to thank Patrick Dattalo, Ph.D for his co-leadership in this research project, his help with developing the measure, statistical analysis, and interpretation. Also, the participants in the focus and stakeholder consultation groups, who served as the measure’s expert panel reviewers of the initial item pool and underlying theoretical model.
- Allen, J., & van der Velden, R. (2005). The role of self-assessment in measuring skills. Reflex Working Paper 2. Maastricht: ROAGoogle Scholar
- Corrigan, P. W., Rafacz, J. D., Hautamaki, J., Walton, J., Rüsch, N., Rao, D.,& Reeder, G. (2010). Changing stigmatizing perceptions and recollections about mental illness: The effects of NAMI’s In Our Own Voice. Community Mental Health Journal, 46, 517–522. doi: 10.1007/s10597-009-9287-3.CrossRefPubMedGoogle Scholar
- Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53.Google Scholar
- DeVellis, R. F. (2003). Scale development: Theory and application (2nd ed.). Thousand Oaks, CA: Sage Publications.Google Scholar
- Faulkner, A., & Layzell, S. (2000). Strategies for living. London: Mental Health Foundation.Google Scholar
- Gabbidon, J., Clement, S., van Nieuwenhuizen, A., Kassam, A., Brohan, E., Norman, I., & Thornicroft, G. (2013). Mental illness: Clinicians’ Attitudes (MICA) scale—psychometric properties of a version for healthcare students and professionals. Psychiatry Research, 206, 81–87. doi: 10.1016/j.psychres.2012.09.028.CrossRefPubMedGoogle Scholar
- Goldsmith, L. P., Lewis, S. P., Dunn, G., & Bentall, R. P. (2015). Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: An instrumental variable analysis. Psychological Medicine, 45(11), 2365–2373. doi: 10.1017/S003329171500032X.CrossRefPubMedPubMedCentralGoogle Scholar
- Groves, R. M., Fowler, F. J., Couper, M. P., Lepkowski, J. M., Singer, E., & Tourangeau, R. (2009). Survey methodology (2nd ed.). Hoboken, NJ: Wiley.Google Scholar
- Kassam, A., Glozier, N., Leese, M., Henderson, C., & Thornicroft, G. (2010). Development and responsiveness of a scale to measure clinicians’ attitudes to people with mental illness (medical student version). Acta Psychiatrica Scandinavica, 122, 153–161. doi: 10.1111/j.1600-0447.2010.01562.x.CrossRefPubMedGoogle Scholar
- Kopera, M., Suszek, H., Bonar, E., Myszka, M., Gmaj, Ilgen, M., & Wojnar, M. (2015). Evaluating explicit and implicit stigma of mental illness in mental health professionals and medical students. Community Mental Health Journal, 51, 628–634. doi: 10.1007/s10597-014-9796-6.CrossRefPubMedGoogle Scholar
- Maslach, C. (1993). Burnout: A multidimensional perspective. In W. B. Schaufeli, C. Maslach & T. Marek (Eds.), Professional burnout: Recent developments in theory and research (pp. 19–32). Washington, DC: Taylor & Francis.Google Scholar
- Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. New York, NY: McGraw-Hill.Google Scholar
- Rogers, R. (1994). Client-centered therapy. London: Constable.Google Scholar
- Rogers, R. (1995). On becoming a person: A therapist’s view of psychotherapy. London: Constable.Google Scholar
- Sudman, S., & Bradburn, N. M. (1982). Asking questions: A practical guide to questionnaire design. San Francisco, CA: Jossey-Bass.Google Scholar
- The President’s New Freedom Commission on Mental Health. (2003). Achieving the promise. Transforming mental health care in America. final report. DHHS Pub. No. SMA-03-3832 (Rockville, Md.). Retrieved from: http://www.cartercenter.org/documents/1701.pdf.
- U.S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.Google Scholar
- Wilkins, B. T., & Abell, N. (2010). Validation of the Mental illness Stigma Scale for Mental Health Professionals. Paper presented at the annual meeting of the Society for Social Work Research, San Francisco, CA.Google Scholar