Advancing Mental Health Research for Global Well-Being

Mental health is a cornerstone of human flourishing, social cohesion, and sustainable development. Yet, for millions of people mental health quality of life remains underexplored. The work shared here reflects a commitment to strengthening mental health quality of life research.
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Mental health quality of life in low- and middle-income countries: an assessment tool - Discover Psychology

Mental health quality of life is a key factor for overall well-being, social wellness, thriving, and progress, but is seldom addressed in low- and middle-income countries. This study aimed to develop a psychometrically appropriate assessment tool of mental health quality of life (MHQoL) for use in the general population. The sample consisted of 1357 individuals selected non-randomly. Items were generated based on the conceptual models of the WHO, Duangchan and Mathews, Ferrans et al., Connell et al., and van Krutgen et al., following a systematic review of the research literature and expert participation. Exploratory (EFA) and confirmatory factor (CFA) analyses were conducted to test reliability, validity indexes, and model fit. The high internal consistency (α = 0.97) and the structure of 8 factors identified through EFA, which explained 74% of the variance, along with the good model fit obtained with CFA, provide a robust foundation for the psychometric properties of this assessment tool. The dimensions of MHQoL were found to align with previous research and correspond to components of mental health. The practical information obtained from this scale can pave the way for researchers, scholars, and health professionals to design culturally sensitive and targeted interventions that address mental health quality of life dimensions. By identifying and differentiating the structures of mental health quality of life in each community and implementing intervention programs targeted at specific dimensions, it is possible to enhance mental health, prevent further deterioration, and improve quality of life, particularly in low- and middle-income countries like Mexico.

Mental health quality of life (MHQoL) is increasingly recognized as a cornerstone of individual well-being, social cohesion, and sustainable development. Beyond the absence of mental illness, MHQoL encompasses people’s subjective experiences of emotional balance, psychological functioning, social connectedness, autonomy, purpose, and the capacity to lead meaningful lives. Despite its centrality to global health agendas, MHQoL remains insufficiently studied and inadequately measured in many low- and middle-income countries (LMICs), where sociocultural realities, structural inequalities, and contextual stressors shape mental health experiences in ways that are often poorly captured by instruments developed in high-income settings. This gap in measurement limits the ability of researchers, policymakers, and practitioners to generate evidence that is culturally valid, contextually grounded, and actionable for improving mental health outcomes at the population level.

 In response to this critical need, our research aimed to develop and validate a comprehensive, culturally grounded assessment tool for mental health quality of life in the general population. Anchored in internationally recognized conceptual models of mental health and quality of life, the instrument was designed to move beyond deficit-based frameworks and to capture a multidimensional, strengths-oriented understanding of mental health. From its inception, the development process emphasized cultural relevance, conceptual clarity, and methodological rigor. An interdisciplinary panel of experts in mental health, psychometrics, public health, and social sciences collaborated to ensure that the construct of MHQoL was operationalized in a way that resonates with lived experiences while maintaining theoretical coherence and cross-cultural relevance.

 The scale development process followed best practices in psychometric research, including an extensive review of the literature, expert consultations, iterative item refinement, and empirical testing in a large and diverse community sample (N = 1,357). Participants represented a broad cross-section of the general population, allowing for robust evaluation of the instrument’s performance in real-world, non-clinical settings. This focus on the general population is particularly important in LMIC contexts, where mental health research has historically concentrated on clinical samples, often overlooking the broader continuum of mental health experiences that exist outside formal health care systems.

 Psychometric analyses demonstrated that the MHQoL scale possesses excellent internal consistency (Cronbach’s α = .97), indicating a high degree of reliability. Exploratory and confirmatory factor analyses supported a coherent and theoretically meaningful eight-factor structure, accounting for 74% of the total variance. These factors reflect key dimensions of mental health quality of life, capturing emotional, psychological, and social components in a way that aligns with contemporary multidimensional models of mental health. The strength of the factor structure and the proportion of explained variance underscore the robustness of the instrument and its capacity to capture the complexity of MHQoL without sacrificing interpretability or practical utility.

 Importantly, the results provide strong evidence that MHQoL can be reliably and validly measured in culturally diverse contexts when assessment tools are thoughtfully designed and empirically grounded. The scale’s performance suggests that it is sensitive to variations in mental health quality of life across individuals and groups, making it suitable for use in research, community assessments, and program evaluation. By offering a psychometrically sound measure that reflects local realities, this tool addresses a long-standing barrier to advancing mental health research in LMICs: the lack of culturally appropriate instruments that go beyond symptom reduction to assess positive mental health and quality of life.

 The implications of this work extend well beyond measurement. A reliable and culturally sensitive MHQoL assessment tool opens new avenues for understanding how social, economic, cultural, and environmental factors interact to shape mental health across the life course. It enables researchers to identify strengths and vulnerabilities within communities, to monitor changes over time, and to evaluate the impact of policies and interventions aimed at improving mental well-being. For practitioners, the tool offers a structured yet flexible way to assess mental health quality of life in community and preventive settings, supporting early identification of risks and the promotion of protective factors before distress escalates into clinical disorders.

 From a policy perspective, the availability of a validated MHQoL measure has the potential to transform how mental health is conceptualized and prioritized within public health agendas. In countries such as Mexico—where social inequality, violence, economic uncertainty, and limited access to mental health services pose ongoing challenges—evidence generated through culturally grounded tools is essential for informing equitable and effective policy responses. By capturing dimensions of mental health that matter to people’s daily lives, this instrument can support the design of targeted, contextually appropriate interventions that promote resilience, social participation, and psychological flourishing.

 More broadly, this research contributes to a growing global movement that calls for a paradigm shift in mental health—from a narrow focus on pathology to a holistic understanding of well-being and quality of life. It aligns with international efforts to integrate mental health into the Sustainable Development Goals and to recognize mental well-being as both a fundamental human right and a driver of social and economic development. By providing a rigorous yet culturally adaptable tool, our work supports comparative research across settings while honoring local meanings and experiences of mental health.

 Therefore, this tool opens new possibilities for designing targeted, culturally sensitive interventions that strengthen mental health, prevent deterioration, and promote flourishing—particularly in countries like Mexico.

 We hope that this work not only facilitates high-quality research but also inspires a renewed commitment to understanding, measuring, and promoting mental health quality of life as a foundation for human flourishing. Ultimately, by improving how we measure MHQoL, we take a crucial step toward creating mental health systems and societies that enable individuals and communities not merely to survive, but to thrive.

 

 

 

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