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Development of the South Sudan Mental Health Assessment Scale (SSMHAS)

South Sudan has endured decades of conflict, displacement, and social instability, resulting in widespread mental health challenges, particularly among women and vulnerable populations. Despite this high burden, there has historically been no culturally validated tool to accurately assess mental health distress in the South Sudanese context. Existing instruments, developed in other countries, often fail to capture local expressions of psychological suffering (“idioms of distress”), limiting their validity and usefulness for program design, evaluation, and policy planning.

The South Sudan Mental Health Assessment Scale (SSMHAS) was developed to fill this critical gap. It is a culturally grounded, locally validated instrument designed to measure mental health distress among women in South Sudan. The development process followed a participatory, mixed-methods approach:

1. Qualitative research: Free listing interviews and key informant consultations identified common mental health problems and local idioms of distress.
    
2. Scale construction: Items were drafted using the community’s own language, ensuring cultural relevance.
    
3. Field testing: A survey of 3,137 women across 100 communities was conducted to test the scale’s validity.
    
4. Reliability and validity checks: Test–retest, inter-rater reliability, and convergent validity analyses confirmed that the scale reliably measures distress while reflecting local experiences.
    

The final SSMHAS consists of 24 items across six idioms of distress, scored on a 4-point Likert scale (never to always). Psychometric testing demonstrated high internal consistency (α ≈ 0.91) and strong reliability, indicating that the scale is both robust and contextually appropriate.

Significance and Impact:

• Provides a culturally valid tool for mental health assessment in South Sudan.
   
• Enables NGOs, researchers, and government agencies to monitor psychosocial wellbeing and evaluate interventions effectively.
   
• Supports evidence-based program design and policy development for mental health and psychosocial support (MHPSS).
   
• Strengthens community-based approaches by aligning assessment with local understandings of distress.
   

Limitations:

• Validated primarily among women; adaptation is required for men or other populations.
   
• Not intended for clinical diagnosis of psychiatric disorders.
   
• Rural, remote, and ethnolinguistically diverse regions may require further validation.
   

In conclusion, the SSMHAS provides a practical, culturally sensitive instrument to assess mental health needs in South Sudan, filling a critical gap in humanitarian and development practice. It enables stakeholders to understand, monitor, and address mental health distress, paving the way for effective psychosocial interventions and improved wellbeing for vulnerable populations.