A Preliminary Validation of the Korean Version of the Mental Illness: Clinicians’ Attitudes Scale (MICA-4): Psychometric Properties and Healthcare Provider Stigma

OBJECTIVE: Mental illness-related stigma among healthcare providers constitutes a critical barrier to care. The Mental Illness: Clinicians' Attitudes Scale (MICA-4) is a validated measure of healthcare provider stigma, but no Korean-language version exists. Our objective was to develop and validate a Korean version of the MICA-4, examining psychometric properties and associations with healthcare provider characteristics. METHODS: Ninety-two healthcare workers completed the Korean MICA-4. Following rigorous forward and back translation, exploratory factor analysis examined the instrument's structure. Group comparisons tested associations between MICA-4 scores and provider characteristics (specialty, experience, education). RESULTS: Internal consistency was acceptable (α=0.673). An exploratory five-factor structure, broadly consistent with the original instrument, was identified and provisionally retained for interpretation, given the modest sample size and preliminary nature of the study. Psychiatry specialists demonstrated significantly less stigmatizing attitudes than non-psychiatry professionals (M=42.90 vs. 50.08, p<0.001). Mental health education completion within the past 12 months showed the strongest association with reduced stigma (p<0.001). Longer clinical experience was associated with higher stigma. Age, gender, and contact frequency were not significantly associated with stigma scores. CONCLUSION: The Korean MICA-4 shows preliminary evidence of reliability and validity for assessing healthcare provider stigma in Korea, although further validation with larger and more diverse samples is needed before firm conclusions can be drawn. The substantial association between recent mental health education and lower stigma suggests that targeted training programs could be a promising strategy to reduce stigma among healthcare professionals.