Development and Validation of the Mental Health Screening Tool for Children and Adolescents (MHST-CA)

Existing adolescent mental health screening instruments are predominantly symptom-focused, lack integration of biological, psychological, and social dimensions, and have limited validation evidence in Eastern European populations. This study describes the development and validation of the Mental Health Screening Tool for Children and Adolescents (MHST-CA), a brief self-report instrument grounded in the biopsychosocial model. Item generation drew on 22 focus groups (N > 200 participants) and interviews with 31 specialists. An initial 132-item pool was reduced through exploratory factor analysis in a pilot sample (N = 237, ages 10-20) and confirmatory factor analysis in a validation sample (N = 496, ages 10-20, 58.1% female). The final 27-item, three-factor model (Psychological, Biological, Social) demonstrated acceptable fit (CFI = .88, TLI = .87, RMSEA = .07, SRMR = .05) and high internal consistency (total α = .94; subscale α = .82-.90). Concurrent validity was supported by positive correlations with the DASS-Y (r = .71-.82) and CPSS (r = .73), and negative correlations with the WEMWBS (r = -.53 to -.69). Moderate inter-factor correlations (r = .67-.77) provided preliminary discriminant validity evidence. The MHST-CA offers a psychometrically sound, culturally grounded screening tool for Romanian adolescents. Limitations include reliance on self-report and a geographically restricted sample.