A Rasch Analysis of the Mental Health and Recovery Measure: Reliability and Validity
The treatment of serious mental illness has come a long way in just the last few decades, changing even what “mental health recovery” means. Parallel to this development, new measurements have evolved to capture the new meaning of recovery. The current study examined the reliability and validity, of a consumer-driven recovery measure, the Mental Health Recovery Measure (MHRM). The MHRM is a 30-item scale developed based on a grounded theory analysis (Young & Ensing, 1999) of information from individuals with severe and persistent mental illness regarding their understanding of the “lived experience” of recovery. The MHRM has previously been found (Bullock, 2005; Young, Ensing, & Bullock, 2000) to have good internal and test-retest reliability, convergent validity with other measures of recovery, and utility in the assessment of recovery following participation in recovery-focused treatment programs (Bullock, Sage, Hupp, O’Rourke, & Smith, 2009). The psychometric properties of the MHRM have been studied using classical statistical methods, which have limitations. The current study used the Rasch framework (Linacre, 2012a), which has significant advantages over the classical methods, including the ability to make sample-free examinations. The current study used data from 1116 individuals with severe and persistent mental illness who attended the introductory session of the Wellness Management and Recovery (WMR) program in a variety of community mental health centers, consumer operated sites, vocational rehabilitation services and state psychiatric hospitals across Ohio. Analyses revealed that the MHRM has acceptable item and person reliability. However, examination of the response category diagnostics revealed that the 5-point item response scale was not used as expected by participant respondents. A modification of the response categories in which a 3-point response scale was developed revealed improved category functioning. The current 30 items comprising the MHRM appear to measure a single construct and the Rasch analyses did not support deletion of any items or shortening of the measure. The order of item difficulties was consistent with the recovery model; however, problems were identified regarding targeting people with very high and low levels of recovery and potential solutions to these problems are discussed.
Clinical Psychology, recovery, Rasch, mental health, self-report
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