Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS)

Abstract

The Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS) is a comprehensive psychological scale designed to measure an individual’s disposition toward utilizing professional help for psychological distress. Developed as an adaptation and extension of the classic Attitudes Toward Seeking Professional Psychological Help (ATSPPH) Scale, the IASMHS addresses contemporary concerns regarding mental health care utilization, specifically focusing on the influence of personal openness, perceived necessity of help, and sensitivity to stigma. It is a critical instrument for researchers examining barriers to treatment access across diverse populations.

Keywords

IASMHS, Attitudes toward help-seeking, Mental health services, Stigma, Psychological openness, Help-seeking propensity, Psychological assessment, Clinical psychology.

Authors

C.S. Mackenzie, W.L. Gekoski, V.J. Knox, H. Macaulay

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Purpose

The primary purpose of the IASMHS is to provide a nuanced measurement tool for assessing the multifaceted factors influencing an individual’s willingness to seek professional mental health assistance. It moves beyond simple measures of perceived need by dissecting attitudes into distinct, measurable components, allowing researchers to pinpoint specific psychological and social barriers.

This instrument is particularly valuable in clinical and academic settings for identifying groups or individuals who may underutilize services due to internalized stigma, lack of psychological insight, or a belief in self-reliance as the only acceptable solution. By understanding these underlying attitudes, targeted interventions can be developed to improve help-seeking behavior and increase the utilization of services like psychotherapy.

Construct

The IASMHS is structured around three core psychological constructs, which collectively determine an individual’s overall attitude toward seeking professional mental health services:

• Psychological Openness (PO): This factor measures the degree to which an individual is willing to acknowledge internal distress, explore personal issues, and discuss intimate matters with others, particularly professionals. High scores indicate a greater capacity for self-reflection and readiness for therapeutic work.
• Help-Seeking Propensity (HSP): This factor assesses the perceived utility and necessity of professional intervention. It reflects the belief that psychological problems warrant professional attention rather than resolving themselves spontaneously or through self-effort alone.
• Indifference to Stigma (IS): This factor measures the extent to which an individual disregards the potential negative social consequences (embarrassment, shame, or judgment) associated with seeking or having received psychological help. High scores indicate resistance to anticipated public or private stigma.

Validity

The validity of the IASMHS was established through extensive psychometric testing, particularly during its adaptation and extension phase by Mackenzie and colleagues (2004). Construct validity was supported by the scale’s clear differentiation between the three hypothesized factors (PO, HSP, IS). The factor structure was confirmed to be sound and distinct from the original ATSPPH structure.

Convergent validity was demonstrated through expected correlations with measures of related constructs, such as mental health literacy, personal distress, and general social support seeking. Furthermore, the IASMHS has shown utility in predicting actual service utilization and intention to seek help, thus supporting its predictive validity in various demographic and clinical samples, including studies focused on age and gender differences.

Reliability

The IASMHS exhibits strong internal consistency across its subscales. Studies, including those by Mackenzie et al., typically report high reliability coefficients, with the overall scale and its subscales frequently demonstrating Cronbach’s alpha values well above the acceptable threshold of 0.70, often ranging into the 0.80s and 0.90s. This indicates that the items within each factor consistently measure the same underlying construct.

The robust reliability ensures that the scale provides stable and consistent measurements of attitudes, making it a dependable tool for longitudinal studies tracking changes in help-seeking attitudes over time or in response to specific interventions aimed at reducing stigma.

Factor Analysis

The development of the IASMHS utilized exploratory and confirmatory factor analysis to refine the structure of the adapted scale. This analysis confirmed a clear, three-factor solution corresponding precisely to the constructs of Psychological Openness, Help-Seeking Propensity, and Indifference to Stigma. This factor structure represents a significant improvement over the original ATSPPH scale, offering a more detailed diagnostic profile of help-seeking attitudes. The items load cleanly onto their respective factors, supporting the conceptual independence of the three dimensions.

Instrument

Test Type: Self-report questionnaire / Psychological Scale

Format: 24 items rated on a 5-point Likert scale.

Language Available: Primarily English (Original development).

Population Group: General population, students, adults, clinical samples.

Age Group: Adolescents and Adults (typically 18+).

Population Details: Used extensively in studies of university students and aging populations to assess barriers to mental health service utilization.

Test Methodology: Respondents indicate their level of agreement with each statement using the following response format: 0= disagree, 1=somewhat disagree, 2=are undecided, 3=somewhat agree, 4=agree.

Keywords

Mental health, Attitudes, Help-seeking behavior, Psychological services, Shame, Barriers to care, Psychometrics, Stigmatization.

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Authors

Author ORCID Identifier: Not specified in source content.

Affiliation Email addresses: Not specified in source content.

Correspondence Address: Not specified in source content.

Permissions & Fee and Test Year

The IASMHS is generally considered available for academic research purposes, provided proper citation is used. The primary adaptation and extension of the scale were published in 2004 by Mackenzie, Knox, Gekoski, & Macaulay. The instrument itself is often found in the appendices of academic theses and journal articles that utilize it.

The scale items can be found on pages 99-101 of the thesis, “The Relationship between Gender Role Conflict and Attitudes towards Help-Seeking: What is the Role of Maladaptive Coping?” The original PDF can be downloaded here: https://cardinalscholar.bsu.edu/handle/123456789/193356.

Reference’s

• Mackenzie, C.S., Knox, V.J., Gekoski, W.L., & Macaulay, H. (2004). An adaptation and extension of the attitudes toward seeking professional psychological help scale. Journal of Applied Social Psychology, 34, 2410-2433.
• Mackenzie, C.S., Gekoski, W.L., & Knox, V.J. (2006). Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes. Aging & Mental Health, 10, 574-582.
• Adams. David F, (2010). The Relationship between Gender Role Conflict and Attitudes towards Help-Seeking: What is the Role of Maladaptive Coping? Ball State University Muncie, INDIANA. M.A. thesis.

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Items of the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS)

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

1. There are certain problems which should not be discussed outside of one’s immediate family.
2. I would have a very good idea of what to do and who to talk to if I decided to seek professional help for psychological problems.
3. I would not want my significant other (spouse‚ partner‚ etc.) to know if I were suffering from psychological problems.
4. Keeping one’s mind on a job is a good solution for avoiding personal worries and concerns.
5. If good friends asked my advice about a psychological problem‚ I might recommend that they see a professional.
6. ha‎ving been mentally ill carries with it a burden of shame.
7. It is probably best not to know everything about oneself.
8. If I were experiencing a serious psychological problem at this point in my life‚ I would be confident that I could find relief in psychotherapy.
9. People should work out their own problems; getting professional help should be a last resort.
10. If I were to experience psychological problems‚ I could get professional help if I wanted to.
11. Important people in my life would think less of me if they were to find out that I was experiencing psychological problems.
12. Psychological problems‚ like many things‚ tend to work out by themselves.
13. It would be relatively easy for me to find the time to see a professional for psychological problems.
14. There are experiences in my life I would not discuss with anyone.
15. I would want to get professional help if I were worried or upset for a long period of time.
16. I would be uncomfortable seeking professional help for psychological problems because people in my social or business circles might find out about it.
17. ha‎ving been diagnosed with a mental disorder is a blot on a person’s life.
18. There is something admirable in the attitude of people who are willing to cope with their conflicts and fears without resorting to professional help.
19. If I believed I were ha‎ving a mental breakdown‚ my first inclination would be to get professional attention.
20. I would feel uneasy going to a professional because of what some people would think.
21. People with strong ch‎aracters can get over psychological problems by themselves and would have little need for professional help.
22. I would willingly confide intimate matters to an appropriate person if I thought it might help me or a member of my family.
23. Had I received treatment for psychological problems‚ I would not feel that it ought to be “covered up.”
24. I would be embarrassed if my neighbor saw me going into the office of a professional who deals with psychological problems.