Mental Health Screening Instruments for Adult Refugees in Resettlement: A Systematic Review of Psychometric Properties

This review examines studies reporting the psychometric properties of the three most frequently used mental health screening tools for refugees: the Hopkins Symptom Checklist (HSCL-25), the Harvard Trauma Questionnaire (HTQ), and the Refugee Health Screener (RHS-15 and RHS-13). The review utilized the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. We searched the PubMed and PsycInfo databases for relevant studies published between 2008 and 2024. From 2505 studies screened, 13 were ultimately included in the review. Five studies analysed the HSCL-25, showing good internal consistency but problems with cross-cultural and structural validity. Three studies on the HTQ focused on measurement invariance, showing mixed results in cross-cultural and structural validity. One study revised the HTQ to match updated diagnostic criteria, but this revision has not yet been validated. Five studies established the content validity, internal consistency, and criterion validity of the RHS. Additionally, they reported similar psychometric properties for the 13-item and 15-item versions of the RHS. However, only one of these studies examined structural validity, and none examined cross-cultural validity. In conclusion, although the HSCL-25 and HTQ were seminal contributions in refugee mental health screening, more recent evidence suggests that the RHS has since emerged as the preferred instrument.