Validation of the Mental Illness: Clinicians' Attitudes Scale: The Factor Structure and Psychometric Properties of the Brazilian Version

In the literature, few instruments have been identified to measure the stigma of health professionals toward people with mental illness. In Brazil, until 2021, the literature did not indicate the validation of an instrument or the construction of an instrument for this purpose. Considering this gap, this study aimed to validate and estimate the reliability of the Mental Illness: Clinicians' Attitudes Scale, version 4 (MICA-4) for the Brazilian context, examining the psychometric properties through the analysis of its internal consistency and factor structure.

Psychometric testing was completed in a sample of health professionals from Primary HealthCare Units. Reliability analysis was conducted in SPSS v23. Cronbach's Alpha and item total correlation were used. The dimensionality of the MICA was explored using exploratory factor analysis (EFA) in Mplus 8.2.

A total of 195 health professionals participated in the research. Cronbach's Alpha was 0.68 and according to the reliability analysis, items 10 and 12 of the original version were deleted, resulting, therefore, in 14 items. In addition, we demonstrated that it is possible to have only two factors instead of five factors, which is the number of factors in the original version of the MICA-4.

This validated instrument for the Brazilian context can serve as an important tool in understanding the phenomenon of the stigma of health professionals toward people with mental illness and, consequently, in promoting anti-stigma strategies in Brazil.