Reliability and validity of Malayalam version of 12-item Community Attitude Towards Mental Illness (CAMI-12) questionnaire

Background: Community attitude toward mental illness (CAMI) is an important determinant in the management of people with psychiatric disorders. Stigma interferes with diagnosis, treatment, and rehabilitation of all mental disorders. Even though studies have been done to evaluate knowledge, attitude, and behaviors toward psychiatric patients, no tools are available in the local language, Malayalam, for assessing CAMI. A validated and reliable Malayalam tool is an essential prerequisite for assessing the level of stigma in the local population. The objectives of our study were to assess the reliability and validity of the Malayalam version of the 12-item Community Attitude towards Mental Illness (CAMI-12) Questionnaire and to estimate the proportion of caregivers of patients with MI having a high level of stigma as per CAMI-12. Methods: This observational study was done in Government Medical College, Kottayam, from June 2021 to December 2021, after getting the approval of the Institutional Ethics Committee. Written informed consent was obtained from the participants before recruiting them for the study. One hundred and twenty caregivers of patients with mental illness were recruited by consecutive sampling, and they completed the Malayalam version of CAMI-12 at baseline and after four weeks. Internal consistency was assessed using Cronbach’s alpha. Results: The Malayalam version of CAMI-12 total score and the subscales for Tolerance and Support (TS) and Prejudice and Exclusion (PE) had a high internal consistency with Cronbach’s alpha values of 0.90, 0.89 and 0.90, respectively. Conclusions: Our study demonstrated good reliability and validity for the Malayalam version of CAMI-12. The proportion of caregivers with a high level of stigma was found to be 28.3% (95% Confidence Interval [95% CI] = 20.2-36.4%).