Validating the Nepalese Short Attitudes Toward Mental Health Problems Scale (N-SATMHPS): A Culturally Sensitive Tool for Assessing Mental Health Stigma

(1) Background: Negative attitudes toward mental health problems remain a barrier for help-seeking, especially in collectivist, lower-middle-income countries like Nepal. While the Attitudes Towards Mental Health Problems Scale (ATMHPS) has been used globally, it has not been formally validated for Nepalese populations. This study aimed to culturally adapt and psychometrically validate a concise Nepalese version of the scale. (2) Methods: We conducted a cross-sectional study and recruited participants through an opportunity sampling method. We developed the Nepalese Short Version of the Attitudes Towards Mental Health Problems Scale (N-SATMHPS) using Dataset 1 (<i>n</i> = 384) and validated it with Dataset 2 (<i>n</i> = 803). Items were selected based on internal consistency indices. Fourteen items showing the strongest reliability were retained from the original seven subscales. A confirmatory factor analysis and internal consistency testing were used to assess psychometric properties. (3) Results: The N-SATMHPS showed a strong internal consistency (α = 0.74-0.92) and excellent model fit (χ<sup>2</sup>/df = 1.92, CFI = 0.982, TLI = 0.970, RMSEA = 0.049, SRMR = 0.026). Correlations with the full version ranged from r = 0.79 to 0.96. Discriminant validity with Mental Health Literacy Questionnaire-Young Adults (MHLQ-YA) showed weak but significant correlations, confirming construct distinction. (4) Conclusions: The scale captured key Nepalese cultural constructs, such as shame and family honor. It also aligned with collectivist cultural expectations. The N-SATMHPS demonstrates strong psychometric performance and cultural relevance. It is suitable for research and intervention work aimed at reducing stigma and improving mental health in Nepal.

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Journal
International Journal of Environmental Research and Public Health
Published
2025-12-18
DOI
https://doi.org/10.3390/ijerph22121884
Primary Topic
Mental Health Treatment and Access
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article
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article

Validating the Nepalese Short Attitudes Toward Mental Health Problems Scale (N-SATMHPS): A Culturally Sensitive Tool for Assessing Mental Health Stigma

Takashi Yoshioka, Yasuhiro Kotera, Rory Colman, Dev Bandhu Poudel
International Journal of Environmental Research and Public Health
Mental Health Treatment and Access
article

Validating the Nepalese Short Attitudes Toward Mental Health Problems Scale (N-SATMHPS): A Culturally Sensitive Tool for Assessing Mental Health Stigma

Takashi Yoshioka, Yasuhiro Kotera, Rory Colman, Dev Bandhu Poudel
article en

Abstract

(1) Background: Negative attitudes toward mental health problems remain a barrier for help-seeking, especially in collectivist, lower-middle-income countries like Nepal. While the Attitudes Towards Mental Health Problems Scale (ATMHPS) has been used globally, it has not been formally validated for Nepalese populations. This study aimed to culturally adapt and psychometrically validate a concise Nepalese version of the scale. (2) Methods: We conducted a cross-sectional study and recruited participants through an opportunity sampling method. We developed the Nepalese Short Version of the Attitudes Towards Mental Health Problems Scale (N-SATMHPS) using Dataset 1 (<i>n</i> = 384) and validated it with Dataset 2 (<i>n</i> = 803). Items were selected based on internal consistency indices. Fourteen items showing the strongest reliability were retained from the original seven subscales. A confirmatory factor analysis and internal consistency testing were used to assess psychometric properties. (3) Results: The N-SATMHPS showed a strong internal consistency (α = 0.74-0.92) and excellent model fit (χ<sup>2</sup>/df = 1.92, CFI = 0.982, TLI = 0.970, RMSEA = 0.049, SRMR = 0.026). Correlations with the full version ranged from r = 0.79 to 0.96. Discriminant validity with Mental Health Literacy Questionnaire-Young Adults (MHLQ-YA) showed weak but significant correlations, confirming construct distinction. (4) Conclusions: The scale captured key Nepalese cultural constructs, such as shame and family honor. It also aligned with collectivist cultural expectations. The N-SATMHPS demonstrates strong psychometric performance and cultural relevance. It is suitable for research and intervention work aimed at reducing stigma and improving mental health in Nepal.

International Journal of Environmental Research and Public HealthVol. 22(12)
SHOWA Medical University (JP), University of Nottingham (GB), Keio University (JP), University of Derby (GB), Grande International Hospital (NP), Manmohan Memorial Institute of Health Sciences (NP), SHOWA Medical University Hospital (JP), Azerbaijan University (AZ), The University of Osaka (JP)
Openalex Percentile: Top 54%
Mental Health Treatment and Access
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