Cultural adaptation, translation and validation of Sinhala and Tamil versions of mental health literacy scale

Background: Mental Health Literacy (MHL) refers to the “knowledge and beliefs about mental disorders that help their recognition, management, or prevention”. It is a key determinant of mental health. Although several tools are available to assess MHL, commonly used methods like vignette interviews are time-consuming and lack a scale-based scoring system. Most available tools lack psychometric data, and none measure all attributes of mental health literacy. The Mental Health Literacy Scale (MHLS), a 35-item comprehensive questionnaire, was developed to address these issues. Currently, there are no validated scales for Mental Health Literacy in Sri Lanka.
Aims: This study aimed to culturally adapt, translate, and validate MHLS into Sinhala (MHLS-S) and Tamil (MHLS-T), thus filling the gap for a suitable tool to evaluate MHL in Sri Lanka.
Methods: Two bilingual experts independently carried out forward and backward translations. Cultural adaptation was conducted using the Delphi method. A multidisciplinary panel performed face and content validation. Reliability was assessed using a test-retest approach. The same questionnaire was administered to a sample of 25 purposely selected university students over a two-week interview.
Results: All experts rated all the items in the questionnaire in both Sinhala and Tamil between 7 and 9. The experts’ suggestions were incorporated into MHLS-S, and there were no suggestions for questions in MHLS-T. Reliability values for MHLS-S and MHLS-T were above 0.9.
Conclusion: The MHLS-S and MHLS-T attributes showed excellent reliability and validity in measuring mental health literacy among the Sinhala and Tamil-speaking populations in Sri Lanka.