Opinions About Mental Illness Scale

Abstract

The Opinions About Mental Illness Scale (OMI), developed by Jacob Cohen and E. L. Struening in 1962, is a classic psychometric instrument designed to measure the underlying dimensions of attitudes and beliefs regarding severe mental illness. The scale was initially developed for and validated among hospital personnel. The OMI is comprehensive, consisting of 51 items that explore various facets of mental illness, including its cause, clinical description, treatment modalities, and prognosis.

The items were synthesized primarily from quotations collected during case conferences and supplemented with material from existing attitude scales. The OMI operationalizes five core opinion-attitude dimensions: Authoritarianism, Benevolence, Mental Hygiene Ideology, Social Restrictiveness, and Interpersonal Etiology. Responses are structured using a 6-point Likert-type response scale, allowing for detailed and nuanced measurement of these complex attitudes.

Keywords

Mental Hospital Personnel, Attitudes, Test Development, Rating Scales, Mental Illness (Attitudes Toward), Health Personnel Attitudes, Social Restrictiveness, Psychometrics

Authors

Jacob Cohen, E. L. Struening

Purpose

The primary purpose of the Opinions About Mental Illness Scale (OMI) is to systematically quantify and assess the prevailing opinions and attitudes concerning severe mental illness held by individuals working in psychiatric or mental health settings, specifically hospital personnel. By identifying underlying attitudinal dimensions, the scale provides critical insight into institutional culture and potential attitudinal barriers to effective patient care and therapeutic rehabilitation.

The instrument was foundational in early psychological research regarding stigma and professional viewpoints within psychiatric institutions. It aims to establish measurable dimensions of these often subjective beliefs, allowing researchers to evaluate how different staff groups (e.g., nurses, physicians, and administrators) perceive patients and their conditions relative to established models of mental health care.

Construct

The core psychological construct measured by the OMI is Attitudes toward Mental Illness. This construct is recognized as multidimensional and is operationalized through five distinct, measurable sub-dimensions or factors identified during the scale’s development:

• Authoritarianism: Reflects beliefs that mental patients are socially inferior, require strict control, and should remain institutionalized.
• Benevolence: Represents a paternalistic and kindly, yet often condescending, view that suggests mental patients are dependent and helpless victims of their condition.
• Mental Hygiene Ideology: Encompasses modern, therapeutic beliefs emphasizing psychological understanding, environmental factors, and the potential for rehabilitation and social reintegration.
• Social Restrictiveness: Measures the desire to keep mental patients segregated from the general community due to perceived danger, unpredictability, or threat to social order.
• Interpersonal Etiology: Focuses on the belief that mental illness arises primarily from environmental stress, interpersonal relationships, or psychological trauma, rather than purely constitutional or biological factors.

Validity

The OMI demonstrated acceptable levels of factor validity in its initial testing. Validity coefficients, calculated across the five subscales (A through E) and across two distinct large mental hospitals, showed considerable variation. Specifically, validity coefficients ranged from a low of .43 (observed for a scale, likely Social Restrictiveness, in Hospital I) up to a high of .89 (observed for another scale, likely Authoritarianism, in Hospital I).

This range suggests that while certain attitude dimensions measured by the scale exhibited strong and consistent alignment with their theoretical construct, other dimensions exhibited weaker structural validity in specific organizational settings. The original scale development emphasized content validity by deriving items directly from real-world clinical discussions.

Reliability

The reliability of the OMI was assessed primarily using measures of internal consistency, quantified through Alpha coefficients. Reliability estimates showed significant variability across the different subscales and the two large mental hospitals where the testing occurred. The coefficients spanned a wide range, from a notably low .21 (observed for Scale D in Hospital I) to a robust high of .82 (observed for Scale A in Hospital I).

The low reliability observed for certain subscales indicates that items within those factors may not have consistently measured a unified construct in all tested environments. Conversely, the higher alpha coefficients observed for other factors demonstrate strong internal coherence for those specific attitude dimensions, suggesting they are reliable measures of their intended constructs.

Factor Analysis

Although specific details regarding the rotational methods or precise statistical outcomes of the factor analysis were not explicitly detailed in the source summary, the scale’s structure confirms that factor analysis was a fundamental component of the scale’s construction by Cohen and Struening in 1962. This procedure was essential for reducing the initial item pool and identifying the five orthogonal dimensions (Authoritarianism, Benevolence, Mental Hygiene Ideology, Social Restrictiveness, and Interpersonal Etiology) that form the basis of the OMI.

The successful identification and isolation of these five dimensions established the OMI as a robust, multidimensional instrument capable of differentiating complex professional attitudes toward mental illness among psychiatric personnel.

Instrument

Test Type: Rating Scale

Format: 51 items rated on 6-point Likert-type response scales (ranging from strongly agree to strongly disagree).

Language Available: English (Original development language).

Population Group: Human; Male; Female

Age Group: Adulthood (18 years & older)

Population Details: Sample: Mental Hospital Personnel; Location: United States. The scale is classified under assessment tools related to Treatment, Rehabilitation, and Therapeutic Processes.

Test Methodology: Paper-and-pencil administration method. The scale uses standardized scoring based on the five identified factors derived from the initial factor analysis.

Keywords

Mental Health Personnel, Attitudes Toward Mental Illness, Psychometrics, Test Construction, Authoritarianism, Benevolence, Social Restrictiveness, Interpersonal Etiology.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Not provided in source.

Permissions & Fee and Test Year

The scale was originally published and tested in 1962. The test items are indicated as available. Information regarding current permission requirements or associated fees for commercial or large-scale academic use is not provided in the source material, but inquiries should be directed toward the publisher of the original journal article.

Reference’s

Cohen, J., & Struening, E. L. (1962). Opinions about mental illness in the personnel of two large mental hospitals. The Journal of Abnormal and Social Psychology, 64(5), 349–360. DOI: https://doi.org/10.1037/h0045526

Items of the Opinions About Mental Illness Scale

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The specific 51 items comprising the Opinions About Mental Illness Scale were not included in the source content summary. Users interested in the full item list should consult the original 1962 publication by Cohen & Struening. The primary source reference, including the DOI, is provided above: https://doi.org/10.1037/h0045526.