The Functioning Assessment Scale for Mental Health: Development and validation

The goal of this study was to develop and validate the Functioning Assessment Scale for Mental Health (FAS-MH), a multidimensional instrument grounded in the International Classification of Functioning, Disability, and Health (ICF). The FAS-MH is designed to assess key functioning domains and environmental factors in individuals with mental disorders.

The development process involved item generation in both Spanish and English, followed by content validation through a two-round Delphi survey with expert panels (20 and 12 professionals, respectively). The Spanish version was then tested in a sample of 334 adults diagnosed with bipolar disorder, depression, or schizophrenia to examine its dimensional structure, internal consistency, and relationships with other variables.

The final 37-item scale covers 34 second-level ICF categories across three domains: Body Functions, Activities and Participation, and Environmental Factors. Confirmatory factor analysis supported a hierarchical model with four first-order factors and one second-order Functioning factor. The FAS-MH showed excellent internal consistency (α = 0.85-0.95; ω = 0.90-0.96) and moderate to strong correlations with established measures of disability, health status, and quality of life.

Content validation was based on a small sample, only the Spanish version of the FAS-MH was tested psychometrically, and associations with clinical outcomes, symptom severity, or clinician-rated assessments were not explored.

The FAS-MH is the first instrument to comprehensively incorporate all ICF components for assessing functioning in individuals with mental disorders. The Spanish version demonstrated strong psychometric properties, providing a brief and user-friendly tool for clinical and research use.