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Reliability and Validity of the Mental Health Literacy Scale (MHLS) Among Malaysian Medical Students

Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Mental health literacy (MHL) is critical for medical students, who encounter high rates of depression, anxiety, and burnout. No validated tool currently exists to measure MHL among Malaysian medical students. Objective: This study tested the reliability and validity of the Mental Health Literacy Scale (MHLS) in this population. Methods: A cross-sectional study was conducted at Manipal University College Malaysia (August–October 2025). A total of 273 clinical-phase medical students completed the 35-item MHLS (response rate: 89.5%; 66.3% female; mean age 22.9 years). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed, alongside reliability assessment using Cronbach's alpha and McDonald's omega. Results: After removing two poorly performing items, a five-factor, 33-item model was identified, explaining 63.41% of total variance: Mental Health Attitudes (α = 0.94), Disorder Recognition and Professional Help (α = 0.90), Help-Seeking Orientation (α = 0.91), Information-Seeking Knowledge (α = 0.88), and Self-Management and Help Knowledge (α = 0.65). CFA demonstrated acceptable fit (CFI = 0.91, RMSEA = 0.06). The five-factor model outperformed both one-factor (CFI = 0.14) and four-factor alternatives (CFI = 0.04). Overall reliability was excellent (α = 0.90, ω = 0.80), though the Self-Management subscale showed suboptimal validity (AVE = 0.41). Conclusion: The 33-item MHLS demonstrates acceptable reliability and validity for measuring MHL among Malaysian medical students. The Self-Management subscale requires further refinement. Cultural context influences the scale's factor structure, and Factor 5 scores should be interpreted cautiously. The findings point to a need for targeted curriculum interventions on self-management strategies and support multi-site replication across diverse Malaysian populations.
Language: English
Field: Psychology
Open Access status: diamond
OpenAlex ID: W7224687656
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