Academic journal article Ethical Human Psychology and Psychiatry

Mental Illness Beliefs Inventory: A Preliminary Validation of a Measure of the Level of Belief in the Medical Model of Mental Illness

Academic journal article Ethical Human Psychology and Psychiatry

Mental Illness Beliefs Inventory: A Preliminary Validation of a Measure of the Level of Belief in the Medical Model of Mental Illness

Article excerpt

The Mental Illness Beliefs Inventory (MIBI) measures the extent to which an individual subscribes to the medical model of mental illness. This article reports the results of two preliminary validation studies. The first study establishes the initial psychometric properties for the MIBI, based on a sample of 222 students in the helping professions; the second study tests the model established in the first study with an additional 270 students. The MIBI performs well as a composite instrument measuring belief in the medical model of mental illness. This instrument shows promise for examining the extent to which individual beliefs affect mental health practice.

Keywords: medical model; mental disorder; social work

In helping professions such as psychology, social work, counseling, and psychiatry, the medical model is commonly used to explain disturbed or disturbing behavior (Lacasse & Gomory, 2003). Medical model terminology such as "mental illness," "mental disorder," and "biologically based brain disease" are often used interchangeably to describe both the putative cause and the nature of disturbing human behavior (Boyle, 2002; Leo, 2004). However, critics have argued that in contrast to well-validated medical diagnoses such as cancer and hypertension, mental disorders are accorded disease status without meeting the classic Virchowian criteria for disease (Szasz, 2001). This lack of objective criteria for mental disorders is made clear in the U.S. Surgeon's General Report on Mental Health, which states that "there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify [mental] illness" (U.S. Department of Health and Human Services, 1999, p. 44). Given unknown etiology and the absence of valid and reliable measurement of mental disorders (Kutchins & Kirk, 1992), a wide range of beliefs regarding mental disorder are possible. Possible beliefs range from that of mental disorder as scientifically established brain disease (Andreason, 1985, 2001) to mental disorder as deviance (Scheff, 1999) to mental disorder as metaphorical rather than genuine bodily disease (Szasz, 1987).

Despite its potential importance, there is a paucity of research measuring belief in the medical model among mental health professionals (although see Colombo, Bendelow, Fulford, & Williams, 2003). Measurement of this belief could yield important information for mental health practice. This belief may impact how helping professionals treat their clients, view their behavior, and decide when and if medical intervention is necessary (e.g., when a referral for psychotropic medication is appropriate). Furthermore, since some of the beliefs inherent in the contemporary medical model may have flimsy empirical underpinnings (Lacasse & Leo, 2005), such measurement has the potential to identify problem areas in knowledge development within the field of mental health.


Instruments have been developed to measure attitudes and beliefs regarding mental illness, but only a few have focused on the medical model. Golding, Becker, Sherman, and Rappaport (1975) developed the Behavioral Expectations Scale (BES) to measure adherence to the medical model, but the BES has lackluster psychometric properties. Morrison (1979) developed the Client Attitude Questionnaire (CAQ), which measured belief in the psychosocial model, partially characterized by a lack of belief in the medical model. Nevid and Morrison (1980) improved on the CAQ by developing the Libertarian Mental Health Ideology Scale (LMHIS). The LMHIS appears to measure the degree of belief in the Szaszian viewpoint (Szasz, 1987) but may be inaccessible to those not already familiar with this point of view (e.g., asking respondents to agree or disagree with the statement "Mental illness is a myth" without context may be problematic in a modern context).

Milling (1981) critiqued previous efforts, such as the CAQ, by pointing out that these efforts included flawed items with poor construct validity. …

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