The Community Attitudes Towards Mental Illness (CAMI) Scale 40 Years Later: An Investigation Using Confirmatory Factor Analysis and Free-Response Data

Abstract

The community attitudes towards mental illness scale (CAMI) is widely used to measure authoritarianism, benevolence, social restrictiveness, and community mental health attitudes held by general populations and medical professionals. This study compares the fit of published alternative factor structures of the CAMI to a general population English-speaking sample and examines what mental illnesses individuals think about when responding. Using data from 749 US MTurk participants, confirmatory factor analysis supported a modified version of Morris' (2012) structure — fear/exclusion, social control, and goodwill — χ²(183) = 1094.44, p < 0.001, RMSEA = 0.08, CFI = 0.90, SRMR = 0.06. Most participants (73.6%) considered specific mental illnesses, with bipolar disorder, depression, and schizophrenia most common. Some found challenges defining mental illness. Comparing structures of a widely cited tool and identifying what respondents think about while completing the scale assists the many researchers using the CAMI. This clarifies our understanding of community stigma and improves our capacity to reduce it.