Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries – A bifactor ESEM representation

Dorottya Őri, Péter Szocsics*, Tamás Molnár, Lucie Bankovska Motlova, Olga Kazakova, Sabrina Mörkl, Michael Wallies, Mohamed Abdulhakim, Sylvie Boivin, Krista Bruna, Carolina Cabacos, Elvira Anna Carbone, Elona Dashi, Giovanni Grech, Stjepan Greguras, Iva Ivanovic, Kaloyan Guevara, Selay Kakar, Konstantinos Kotsis, Ida Maria Ingeholm KlinkbyJovana Maslak, Shevonne Matheiken, Ana Mirkovic, Nikita Nechepurenko, Angelis Panayi, Ana Telma Pereira, Edith Pomarol-Clotet, Shaeraine Raaj, Polona Rus Prelog, Joan Soler-Vidal, Robertas Strumila, Florian Schuster, Helena Kisand, Ann Hargi, Gumru Ahmadova, Matus Vircik, Helin Yilmaz Kafali, Natalia Grinko, Zsuzsa Győrffy, Sandor Rózsa

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
19 Downloads (Pure)


Aims: To measure the stigma of healthcare providers toward people suffering from mental illness, the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) is a commonly applied instrument. However, this scale has not been thoroughly validated in many European countries, its psychometric properties are still unknown and data on practicing psychiatrists is lacking. Therefore, this multicenter study aimed to assess the psychometric characteristics of the 15-item OMS-HC in trainees and specialists in adult and child psychiatry in 32 countries across Europe. Materials and methods: The OMS-HC was conducted as an anonymous online survey and sent via Email to European adult and child psychiatrists. Parallel analysis was used to estimate the number of OMS-HC dimensions. Separate for each country, the bifactor ESEM, a bifactor exploratory structural equation modeling approach, was applied to investigate the factor structure of the scale. Cross-cultural validation was done based on multigroup confirmatory factor analyses and reliability measures. Results: A total of 4,245 practitioners were included, 2,826 (67%) female, 1,389 (33%) male. The majority (66%) of participants were specialists, with 78% working in adult psychiatry. When country data were analyzed separately, the bifactor model (higher-order factor solution with a general factor and three specific factors) showed the best model fit (for the total sample χ2/df = 9.760, RMSEA = 0.045 (0.042–0.049), CFI = 0.981; TLI = 0.960, WRMR = 1.200). The average proportion of variance explained by the general factor was high (ECV = 0.682). This suggests that the aspects of ‘attitude,’ ‘disclosure and help-seeking,’ and ‘social distance’ could be treated as a single dimension of stigma. Among the specific factors, the ‘disclosure and help-seeking’ factor explained a considerable unique proportion of variance in the observed scores. Conclusion: This international study has led to cross-cultural analysis of the OMS-HC on a large sample of practicing psychiatrists. The bifactor structure displayed the best overall model fit in each country. Rather than using the subscales, we recommend the total score to quantify the overall stigmatizing attitudes. Further studies are required to strengthen our findings in countries where the proposed model was found to be weak.

Original languageEnglish
Article number1168929
JournalFrontiers in Public Health
Publication statusPublished - 3 May 2023

Bibliographical note

Funding Information:
DŐ was awarded the National Youth Talent Award in 2020 and 2021 (Ministry of Human Resources, Hungary, (NTP-NFTÖ-20-B-0134 and NTP-NFTÖ-21-B-0280) and the Prominence Award of the Kerpel-Fronius Talent Support Program of Semmelweis University in 2021 (EFOP-3.6.3-VEKOP-16-2017-00009), which covered the expenses of the 1-year account of the online survey platform and the dissemination of the study results at international congresses. SRó was supported by the Károli Gáspár University of the Reformed Church (Grant No. 20754B800).

Publisher Copyright:
Copyright © 2023 Őri, Szocsics, Molnár, Bankovska Motlova, Kazakova, Mörkl, Wallies, Abdulhakim, Boivin, Bruna, Cabacos, Carbone, Dashi, Grech, Greguras, Ivanovic, Guevara, Kakar, Kotsis, Klinkby, Maslak, Matheiken, Mirkovic, Nechepurenko, Panayi, Pereira, Pomarol-Clotet, Raaj, Rus Prelog, Soler-Vidal, Strumila, Schuster, Kisand, Hargi, Ahmadova, Vircik, Yilmaz Kafali, Grinko, Győrffy and Rózsa.


Dive into the research topics of 'Psychometric properties of the Opening Minds Stigma Scale for Health Care Providers in 32 European countries – A bifactor ESEM representation'. Together they form a unique fingerprint.

Cite this