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Multiculturally Sensitive Mental Health Scale (MSMHS): Development, Factor Analysis, Reliability, and Validity
Ruth Chu-Lien Chao and Kathy E. Green University of Denver
Effectively and efficiently diagnosing African Americans’ mental health has been a chronically unre- solved challenge. To meet this challenge we developed a tool to better understand African Americans’ mental health: the Multiculturally Sensitive Mental Health Scale (MSMHS). Three studies reporting the development and initial validation of the MSMHS were conducted with African American student samples. First, an exploratory factor analysis of an initial item pool yielded 5 factors assessing subscales of perceived racism, depression, well-being, anxiety, and suicidal thoughts. Second, a confirmatory factor analysis supported the MSMHS’s 5-dimensional factor structure. Third, test–retest reliability, internal consistency, and validity coefficients supported the viability, use, and potential for continued develop- ment of this new instrument. Implications for theory and research on multicultural mental health scales are discussed.
Keywords: racism, African Americans, psychological distress, anxiety, well-being
The Multiculturally Sensitive Mental Health Scale (MSMHS) was developed to respond to the need for assessing African Amer- icans’ mental health, including perceptions of racism. The absence of an adequate assessment of perceived racism has contributed to a misdiagnosis of African American clients (Clark, Anderson, Clark, & Williams, 1999; Landrine & Klonoff, 1996). Thus, we had three reasons for developing this scale. One, the MSMHS responds to a decades-old belief that if people want to understand African Americans’ psychology, they must understand African Americans’ experience of racism. Specifically, racism is a unique stressor for African Americans (Clark et al., 1999; Harrell, 2000); according to Landrine and Klonoff (1996), 98% of African Amer- icans report experiencing racism in their life. Given that almost every African American experiences racism, it seems prudent to include perceptions of racism in an instrument measuring African Americans’ mental health.
Two, some theorists have urged development of a conceptual model that organizes, explains, and leads to understanding the psychological behavior of African Americans on the basis of an African American worldview (Caldwell, Jackson, Tucker, & Bow-
man, 1999. For example, Caldwell et al. (1999) explained that constructs and instruments developed primarily for Whites have often been inappropriate for African Americans because African American heritage and experiences of slavery and racial oppres- sion have resulted in a framework different from that of other groups. Thus, most current mental health measures that are extrap- olated from Caucasian Whites’ perceptions of mental distress may fail to include assessment of mental health stressors related to perceived racism (Constantine & Sue, 2006; Ridley, 2005; Sue & Sue, 2008). African Americans and White Americans may func- tion psychologically under distinct cosmologies (Broman, Mavad- dat, & Hsu, 2000). These cosmological systems show different ontological systems that reflect their distinct approaches to con- ceptualizing psychological distress. Three, some scholars have found that perceived racism explained additional variance in Af- rican Americans’ psychological distress beyond general stress (Smedley, Myers, & Harrell, 1993). This empirical evidence sug- gests that perceived racism plays a distinct role for African Amer- icans.
Psychological Dimensions of Perceived Racism
Despite the ubiquity of the word racism in everyday language, no consensus on its definition has emerged from the scientific literature. For example, Ponterotto, Utsey, and Pedersen (2006) said that racism is the abstract component of physical racial slavery. Although the physical bondage of slavery has ended in the United States, racism maintains African Americans in a state of psychological oppression. Some scholars have described racism as a relationship between members of oppressed and nonoppressed groups (Constantine & Sue, 2006); others, such as Clark et al. (1999), have indicated racism as a stressor for African Americans, defining it as “beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phe- notypic characteristics or ethnic group affiliation” (p. 805). Indeed,
This article was published Online First April 25, 2011. Ruth Chu-Lien Chao, Counseling Psychology Program and Quantitative
Research Methods Program, Morgridge College of Education, University of Denver; Kathy E. Green, Quantitative Research Methods Program, Morgridge College of Education, University of Denver.
This study was supported by two research grants, the Promoting Psy- chological Research and Training on Health Disparities Issues at Ethnic Minority Serving Institutions (ProDIGS) of the American Psychological Association/Science Directorate and the Division 17 Counseling Psychol- ogy Fund of the American Psychological Foundation, awarded to Ruth Chu-Lien Chao.
Correspondence concerning this article should be addressed to Ruth Chu-Lien Chao, Counseling Psychology Program, University of Denver, 1999 East Evans Avenue, Denver, CO 80208. E-mail: cchao3@du.edu
Psychological Assessment © 2011 American Psychological Association 2011, Vol. 23, No. 4, 876–887 1040-3590/11/$12.00 DOI: 10.1037/a0023710
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