Development and application of the Parental Mental Health Literacy Scale for children aged 0-6

This study aimed to develop and validate the Parental Mental Health Literacy (PMHL) Scale for caregivers of children aged 0-6 years. Initial items were developed based on established mental health literacy and health literacy frameworks and were piloted among 1074 caregivers of children aged 0-6 years in Shanghai, China. Exploratory factor analysis using principal axis factoring with oblique rotation identified a four-factor structure. Confirmatory factor analysis was subsequently conducted to examine the dimensionality of the scale and to compare alternative models, including one-factor, higher-order, and bifactor models. The bifactor model demonstrated the best fit to the data (RMSEA = .088, CFI = .931, TLI = .917). The final version consisted of 28 items across four dimensions: recognition, help-seeking, awareness of parenting and parent-child interaction. Criterion validity was examined using the Strengths and Difficulties Questionnaire (SDQ) and the Early Warning Signs Checklist (WSC). PMHL scores showed modest negative correlations with children's emotional and behavioral difficulties. Internal consistency was high (Cronbach's α = .98; ωh = .89). These findings suggest that the PMHL may serve as a useful instrument for assessing parental mental health literacy in early childhood, although further validation in more diverse samples is warranted.