Beliefs about mental illness in a Spanish-speaking Latin American sample

The US Hispanic population is large and rapidly growing, with serious healthcare disparities. Alarmingly, 67% of Hispanic adults with a mental illness go untreated. Attempts to increase treatment rates have had limited success, likely partly due to stigma beliefs. There is an urgent need to develop and utilize a Spanish language stigma assessment tool. The current study is the first to do so, translating the Beliefs Toward Mental Illness (BTMI; Hirai et al., 2018) scale into Spanish (S-BTMI). Our psychometric findings with English-Spanish bilingual Latinx undergraduate students suggest that the S-BTMI can be a reliable measure of mental illness stigma. The BTMI's 4-factor solution was confirmed by the S-BTMI. Language invariance tests for the S-BTMI and BTMI demonstrated metric invariance and partial scalar invariance. The S-BTMI's factors produced strong internal consistency and two-week test-retest reliability. A previous Latinx sample's BTMI scores were similar to the current S-BTMI scores, except for greater endorsement of incurability beliefs for the Spanish version. Average stigma levels were fairly low in the current sample. Use of the BTMI-S can improve our understanding of stigma, and its relationships to language, culture, acculturation, and treatment-seeking in Latinx communities.