The first stage in developing a scale for children’s mental health literacy: a six-step process for item generation and content validity

Background Mental health literacy refers to the communication, information and knowledge about mental health that helps in preventing psychological problems, promoting well-being, reducing stigmatization and encouraging help-seeking. Mental health literacy has been extensively studied in adult populations. Yet, a scale measuring mental health literacy in children is lacking.Aim This study describes the methodology used to develop the items of a scale on mental health literacy of children aged 8–12 years in France.Methods We followed a six-step process including: (1) writing of the items by three scholars specialized in mental health literacy, (2) revision by twelve multidisciplinary researchers, (3) rating of the items by twenty independent experts (parents, teachers, mental health professionals), (4) interviews with one parent, one teacher, one psychologist, and one child for feedback on the items, and (5) co-design and pre-testing of the items in a class of 23 primary school children. Thirty items in French were produced.Discussion The article presents a multistep approach to create reliable scale items on mental health-related communication and information for children. Best practices need to include the participation of several stakeholders, the foundation on a relevant theoretical model, and the illustration of the items.