Community Mental Health Journal

, Volume 54, Issue 1, pp 33–48 | Cite as

Measuring Mental Health Provider-Based Stigma: Development and Initial Psychometric Testing of a Self-Assessment Instrument

  • Jennifer L. K. CharlesEmail author
  • Kia J. Bentley
Original Paper


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.


Stigma 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.


  1. Abell, N., Springer, D. W., & Kamata, A. (2009). Developing and validating rapid assessment instruments. New York, NY: Oxford University Press.CrossRefGoogle Scholar
  2. Allen, J., & van der Velden, R. (2005). The role of self-assessment in measuring skills. Reflex Working Paper 2. Maastricht: ROAGoogle Scholar
  3. Altindag, A., Yanik, M., Ucok, A., Alptekin, K., & Ozkan, M. (2006). Effects of an antistigma program on medical studets’ attitudes towards people with schizophrenia. Psychiatry and Clinical Neurosciences, 60, 283–288. doi: 10.1111/j.1440-1819.2006.01503.x.CrossRefPubMedGoogle Scholar
  4. Bjorkman, T., Angelman, & Jonsson, M. (2008). Attitudes toward people with mental illness: A cross-sectional study among nursing staff in psychiatric and somatic care. Scandinavian Journal of Caring Sciences, 22, 170–177.CrossRefPubMedGoogle Scholar
  5. Charles, J. L. K. (2013). Mental health provider-based stigma: Understanding the experience of clients and families. Social Work in Mental Health. 11(4), 360–375. doi: 10.1080/15332985.2013.775998.CrossRefGoogle Scholar
  6. Chung, K. F. (2005). Changing attitudes of Hong Kong medical students toward people with mental illness. The Journal of Nervous and Mental Disease, 193(11), 766–768. doi: 10.1097/01.nmd30000185871.20390.c6.CrossRefPubMedGoogle Scholar
  7. Clark, L. A., & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7(3), 309–319.CrossRefGoogle Scholar
  8. Corrigan, P. W., Larson, J., Sells, M., Niessen, N., & Watson, A. C. (2007). Will filmed presentation of education and contact diminish mental illness stigma? Community Mental Health Journal, 43(2), 171–181. doi: 10.1007/s10597-006-9061-8.CrossRefPubMedGoogle Scholar
  9. Corrigan, P. W., & O’Shaughnessy, J. R. (2007). Changing mental illness stigma as it exists in the real world. Australian Psychologist, 42(2), 90–97.CrossRefGoogle Scholar
  10. Corrigan, P. W., & Penn, D. L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54, 765–766.CrossRefPubMedGoogle Scholar
  11. 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
  12. 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
  13. Covarrubias, I., & Han, M. (2011). Mental health stigma about serious mental illness among MSW students: Social contact and attitude. Social Work, 56(4), 317–325.CrossRefPubMedGoogle Scholar
  14. Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of Consulting Psychology, 24, 349–354.CrossRefPubMedGoogle Scholar
  15. DeVellis, R. F. (2003). Scale development: Theory and application (2nd ed.). Thousand Oaks, CA: Sage Publications.Google Scholar
  16. Eack, S. M., & Newhill, C. E. (2008). An investigation of the relations between student knowledge, personal contact, and attitudes toward individuals with schizophrenia. Journal of Social Work Education, 44(3), 77–95. doi: 10.5175/JSWE.2008.200700009.CrossRefGoogle Scholar
  17. Faulkner, A., & Layzell, S. (2000). Strategies for living. London: Mental Health Foundation.Google Scholar
  18. Finklestein, J., Lapshin, O., & Wasserman, E. (2008). Randomized study of different anti-stigma media. Patient Education and Counseling, 71, 204–214. doi: 10.1016/j.pec.2008.01.002.CrossRefGoogle Scholar
  19. 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
  20. 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
  21. 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
  22. Hayward, P., & Bright, J. A. (1997). Stigma and mental illness: A review and critique. Journal of Mental Health, 6(4), 345–354.CrossRefGoogle Scholar
  23. Kaiser, H. F., & Rice, J. (1974). Little jiffy, mark IV. Educational and Psychological Measurement, 34, 111–117.CrossRefGoogle Scholar
  24. 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
  25. Kennedy, S.C., Abell, N., & Mennicke, A. (2014). Initial validation of the mental health provider stigma inventory [Electronic version]. Research on Social Work Practice. doi: 10.1177/1049731514563577.Google Scholar
  26. 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
  27. Lauber, C., Anthony, M., Ajdacic-Gross, V., & Rossler, W. (2004). What about psychiatrists’ attitude to mentally ill people? European Psychiatry, 19, 423–427. doi: 10.1016/j.eurpsy.2004.06.019.CrossRefPubMedGoogle Scholar
  28. Lauber, C., Nordt, C., Braunschweig, C., & Rössler, W. (2006). Do mental health professionals stigmatize their patients? Acta Psychiatrica Scandinavica, 113(Suppl 429), 51–59. doi: 10.1111/j.1600-0447.2005.00718.x.CrossRefGoogle Scholar
  29. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.CrossRefGoogle Scholar
  30. Link, B. G., Struening, E., Cullen, F. T., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54, 400–423.CrossRefGoogle Scholar
  31. 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
  32. Maslach, C., & Jackson, S. E. (1981). The measurement of experience burnout. Journal of Occupational Behaviour, 2, 99–113.CrossRefGoogle Scholar
  33. Modgill, G., Patten, S. B., Knaak, S., Kassam, A., & Szeto, A.C.H. (2014). Opening minds stigma scale for health care providers (OMS-HC): Examination of psychometric properties and responsiveness. BMC Psychiatry, 14(1), 120. doi: 10.1186/1471-244X-14-120.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Nordt, C., Rossler, W., & Lauber, C. (2006). Attitudes of mental health professionals toward people with schizophrenia and major depression. Schizophrenia Bulletin, 32(4), 709–714. doi: 10.1093/schbul/sbj065.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. New York, NY: McGraw-Hill.Google Scholar
  36. O’Connell, M., & Stein, C. (2011). The relationship between case manager expectations and outcomes of persons diagnosed with schizophrenia. Community Mental Health Journal, 47, 424–435. doi: 10.1002/j.2161-1912.2009.tb00101.x.CrossRefPubMedGoogle Scholar
  37. Overton, S. L., & Medina, S. L. (2008). The stigma of mental illness. Journal of Counseling and Development, 86, 143–151.CrossRefGoogle Scholar
  38. Penn, D. L., & Martin, J. (1998). The stigma of severe mental illness: Some potential solutions for a recalcitrant problem. Psychiatric Quarterly, 69, 235–247.CrossRefPubMedGoogle Scholar
  39. Rogers, R. (1994). Client-centered therapy. London: Constable.Google Scholar
  40. Rogers, R. (1995). On becoming a person: A therapist’s view of psychotherapy. London: Constable.Google Scholar
  41. Ross, C. A., & Goldner, E. M. (2009). Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 16, 558–567. doi: 10.1111/j.1365-2850.2009.01399.x.CrossRefPubMedGoogle Scholar
  42. Scheyett, A., & Kim, M. (2004). “Can we talk?”: Using facilitate dialogue to positively change student attitudes toward persons with mental illness. Journal of Teaching in Social Work, 24(1/2), 39–54. doi: 10.1300/J067v24n01_03.CrossRefGoogle Scholar
  43. Schulze, B. (2007). Stigma and mental health professionals: A review of the evidence on an intricate relationship. International Review of Psychiatry, 19(2), 137–155. doi: 10.1080/09540260701278929.CrossRefPubMedGoogle Scholar
  44. Strahan, R., & Gerbasi, K. C. (1972). Short, homogenous versions of the Marlow-Crowne Social Desirability Scale. Journal of Clinical Psychology, 28(2), 191–1932.CrossRefGoogle Scholar
  45. Sudman, S., & Bradburn, N. M. (1982). Asking questions: A practical guide to questionnaire design. San Francisco, CA: Jossey-Bass.Google Scholar
  46. 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:
  47. 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
  48. 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

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.National Catholic School of Social ServiceThe Catholic University of AmericaWashingtonUSA
  2. 2.School of Social WorkVirginia Commonwealth UniversityRichmondUSA

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