Mental Health Recovery Measure (MHRM)

Abstract

The Mental Health Recovery Measure (MHRM) is a widely recognized self-report scale designed to assess the subjective experience and progression of mental health recovery among individuals living with psychiatric conditions. Developed by Bullock and Young, the MHRM moves beyond traditional symptom-focused measures by operationalizing recovery as a multi-dimensional process encompassing personal growth, self-management, empowerment, and integration into the community. The instrument consists of 30 items distributed across eight distinct factors, demonstrating strong overall internal consistency with a reported Cronbach’s Alpha of 0.93 for the total scale. It utilizes a 5-point Likert response format to capture the degree of agreement regarding recovery-oriented behaviors and attitudes.

Keywords

Mental health recovery, self-empowerment, well-being, psychometric scale, mental illness, psychiatric rehabilitation, quality of life, advocacy.

Authors

W.A. Bullock, S.L. Young

Purpose

The primary purpose of the Mental Health Recovery Measure (MHRM) is to provide a standardized, client-centered instrument for quantifying the process and outcomes of mental health recovery. It is specifically designed to capture the individual’s perspective on their recovery journey, focusing on strengths, personal control, and forward momentum rather than solely on deficit identification.

The scale is highly valuable in clinical and research settings for several applications: tracking individual progress over time, evaluating the effectiveness of recovery-oriented programs and interventions, and facilitating collaborative treatment planning by highlighting areas where the individual feels successful or “stuck.”

Construct

The MHRM measures the construct of personal mental health recovery, which is defined as a deep, subjective transformation that allows an individual to live a meaningful life despite the presence of mental health challenges. This construct is operationalized through eight theoretically derived domains, ensuring a comprehensive assessment of recovery dimensions that are salient to the lived experience of those in recovery.

These eight domains—ranging from basic functioning and social engagement to spirituality and self-advocacy—reflect the complexity of recovery as an ongoing, non-linear process involving changes in attitude, belief, and behavioral patterns. The focus is on internal resources and external engagement necessary for sustained well-being.

Validity

Initial studies established the scale’s construct validity through exploratory factor analysis, confirming the hypothesized multi-dimensional structure. The MHRM demonstrates good face validity, as its items directly reflect commonly accepted tenets of recovery models.

Further validation work has supported the utility of the MHRM across diverse clinical populations. For instance, a 2014 study by Armstrong et al. provided evidence validating a brief version of the MHRM specifically for individuals diagnosed with schizophrenia, suggesting that the underlying construct of recovery measured by the MHRM is robust and applicable even in severe and persistent mental illnesses.

Reliability

The MHRM exhibits high overall internal consistency, confirming its reliability as a measure of the total recovery construct. The total scale yielded a robust Cronbach’s Alpha of 0.93, indicating that the 30 items reliably measure a single underlying concept of recovery.

Internal consistency estimates for the subscales vary, reflecting the distinct nature of the factors, but most demonstrate acceptable to strong reliability for research purposes:

• Spirituality: Alpha 0.89
• Overall Well-Being: Alpha 0.86
• Self-Empowerment: Alpha 0.82
• Learning and Self-Redefinition: Alpha 0.79
• Advocacy/Enrichment: Alpha 0.66
• Basic Functioning: Alpha 0.62
• New Potentials: Alpha 0.62
• Overcoming Stuckness: Alpha 0.60

Factor Analysis

The factor structure of the MHRM organizes the 30 items into eight distinct, yet related, dimensions of recovery based on exploratory factor analysis. This structure provides valuable diagnostic information, allowing clinicians and researchers to analyze specific areas of recovery strength and challenge.

The eight factors and their corresponding item distributions are as follows:

• Overcoming Stuckness: Items 1, 2, 3, 4
• Self-Empowerment: Items 5, 6, 7, 8
• Learning and Self-Redefinition: Items 9, 10, 11, 12
• Basic Functioning: Items 13, 14, 15, 16
• Overall Well-Being: Items 17, 18, 19, 20
• New Potentials: Items 21, 22, 23, 24
• Spirituality: Items 25, 26
• Advocacy/Enrichment: Items 27, 28, 29, 30

Instrument

Test Type: Self-Report Questionnaire / Psychometric Scale

Format: 30 items administered using a 5-point Likert scale (0 = Strongly Disagree, 1 = Disagree, 2 = Not Sure, 3 = Agree, 4 = Strongly Agree).

Language Available: English (Primary validation language).

Population Group: Individuals with serious mental illness (e.g., those receiving psychiatric services).

Age Group: Adults (typically 18+).

Population Details: Validated across diverse samples of individuals engaged in the recovery process, including those with diagnoses such as schizophrenia.

Test Methodology: Summed scores are calculated for each of the eight subscales and for the total scale score. Higher scores indicate a greater degree of subjective recovery. The scoring key specifies which items load onto which factor.

Keywords

Self-report measure, recovery assessment, internal consistency, Likert scale, psychiatric services, clinical outcome measurement.

Authors

Author ORCID Identifier: Not specified in source content.

Affiliation Email addresses: Not specified in source content.

Correspondence Address: Young, S. L. & Bullock, W.A. (2003). Available from the University of Toledo, Department of Psychology (#918), Toledo, OH 43606-3390.

Permissions & Fee and Test Year

The initial development and presentation of the MHRM occurred in 2003. Updated normative and psychometric data were subsequently published in 2009 by Bullock. The instrument is often made available for research and clinical use, though specific licensing fees should be confirmed with the authors or the University of Toledo Department of Psychology.

The original PDF containing updated normative and psychometric data can be downloaded here: http://psychology.utoledo.edu/images/MHRM_-_Bullock_-_up‎dated_Normative_and_Psychometric_Data_12-09.pdf

Reference’s

• Bullock, W.A. & Young, S.L. (2003). The Mental Health Recovery Measure (MHRM). Presented at the 111th annual meeting of the American Psychological Association Meeting, Toronto, Canada.

• Young, S. L. & Bullock, W.A. (2003). The mental health recovery measure. Available from the University of Toledo, Department of Psychology (#918), Toledo, OH 43606-3390.

• Bullock, W.A. (2009). The Mental Health Recovery Measure (MHRM): up‎dated Normative Data and Psychometric Properties.

• Armstrong, N.P., Cohen, A.N., Hellemann, G., Reist, C, Young, A.S. (2014). Validating a brief version of the Mental Health Recovery Measure for individuals with schizophrenia. Psychiatric services (Washington, D.C.), 2014; 65(9): 1154-9.

Items of the Mental Health Recovery Measure (MHRM)

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

1. I work hard towards my mental health recovery.

2. Even though there are hard days, things are improving for me.

3. I ask for help when I am not feeling well

4. I take risks to move forward with my recovery.

5. I believe in myself.

6. I have control over my mental health problems.

7. I am in control of my life.

8. I socialize and make friends.

9. Every day is a new opportunity for learning.

10. I still grow and change in positive ways despite my mental health problems.

11. Even though I may still have problems, I value myself as a person of worth.

12. I understand myself and have a good sense of who I am.

13. I eat nutritious meals every day.

14. I go out and participate in enjoyable activities every week.

15. I make the effort to get to know other people.

16. I am comfortable with my use of prescribed mediations.

17. I feel good about myself.

18. The way I think about things helps me to achieve my goals.

19. My life is pretty normal.

20. I feel at peace with myself.

21. I maintain a positive attitude for weeks at a time.

22. My quality of life will get better in the future.

23. Every day that I get up, I do something productive.

24. I am making progress towards my goals.

25. When I am feeling low, my religious faith or spirituality helps me feel better.

26. My religious faith or spirituality supports my recovery.

27. I advocate for the rights of myself and others with mental health problems.

28. I engage in work or other activities that enrich myself and the world around me.

29. I cope effectively with stigma associated with having a mental health problem.

30. I have enough money to spend on extra things or activities that enrich my life.