Psychometric Evaluation of the Malay Version of the Mental Health Knowledge Schedule (MAKS-M): Evidence of Structural and Cultural Limitations

Mental health literacy instruments are often adapted across cultures with the assumption that their constructs remain stable. This study critically evaluates the psychometric performance of the Malay version of the Mental Health Knowledge Schedule (MAKS-M) to examine whether its original structure transfers to the Malaysian context and to identify factors contributing to cross-cultural underperformance.

A cross-sectional survey was conducted among 203 university-based respondents. Reliability indices, confirmatory factor analysis (CFA), and convergent validity testing were used to assess structural performance.

Both subscales showed poor internal consistency (knowledge: α = 0.262; attitude: α = 0.236) and weak item-rest correlations, with reversed items performing particularly poorly. CFA indicated suboptimal model fit (CFI = 0.712, RMSEA = 0.124), with several reversed items showing non-significant or negative factor loadings. Convergent validity was partially supported through significant correlations with the BIPM interest subscale.

The MAKS-M demonstrated significant psychometric limitations, likely due to linguistic ambiguities, cultural incongruities, and conceptual overlap between knowledge and attitude constructs. In particular, reversed items appear especially vulnerable to linguistic and cultural misinterpretation, and the results suggest that the MAKS factor structure may not be inherently stable when applied outside Western sociocultural contexts.

Rather than confirming validity, the study identifies structural and cultural barriers to the reliable use of the MAKS in Malaysia. The findings highlight broader methodological challenges in direct cross-cultural scale adaptation.