Development and Psychometric Validation of a Multidimensional Mental Health Screening Scale for Adults in an Indian Community Sample.

Abstract

Background: Psychological distress in adults frequently remains undetected until it progresses to clinically significant mental illness. Efficient screening instruments capable of identifying early psychological burden are essential for improving access to mental health support. Objective: To develop and psychometrically validate a multidimensional screening instrument assessing psychosocial risk indicators, psychological symptoms, and functional impairment among adults aged 18–60 years. Methods: Scale development followed a multiphasic psychometric design comprising item generation, pilot testing (n = 50), test–retest reliability assessment (n = 50), and cross-sectional validation in 1,005 adults. Participants included non-clinical adults (n = 503), hospital attendants (n = 201), and psychiatric patients (n = 301). The developed scales — Risk, Symptom, and Level of Functioning (LOF) — were evaluated against the 12-item General Health Questionnaire (GHQ-12) and WHO-derived functioning measures. Psychometric evaluation included reliability analysis, concurrent validity testing, receiver operating characteristic (ROC) analysis, and group comparisons. Results: The scales demonstrated acceptable to excellent reliability (Cronbach’s α = 0.78–0.91; ICC = 0.79–0.84). Significant correlations with the GHQ and WHO functioning measures supported concurrent validity. Mean scores increased progressively from non-clinical adults to attendants and psychiatric patients, indicating strong discriminant validity. ROC analysis showed good screening performance, with the Symptom scale demonstrating the highest accuracy (AUC = 0.91). Moderate-to-severe psychological burden was substantially higher among psychiatric patients. Conclusion: The multidimensional screening instrument demonstrated satisfactory psychometric properties and effectively distinguished between non-clinical and clinical populations. The scale may serve as a practical tool for early identification of psychological burden and functional impairment in adult populations.