Stigma Scales

Conditions of use

Researchers in the Section of Community Mental Health (CMH) at King’s College London have developed seven measures relating to different aspects of stigma and discrimination.  These measures are freely available so long as you comply with the below conditions, including completing a short registration survey (this replaces the need to request for permission to use the measures).

If you work or study in a university or health setting the scales are freely available for you subject to the conditions below. Otherwise please contact Professor Sir Graham Thornicroft at graham.thornicroft[a]kcl.ac.uk

Steps to use the scales

Please follow these steps to use the scales. Only if you comply with these conditions is permission for their use granted by King’s College London.

  1. Complete our short scale user registration questionnaire: https://www.surveymonkey.com/s/stigmascalesregistration
  2. On completing the survey, you will be provided with a password allowing you to access the scales at the links below. Please contact Maria Milenova at maria.milenova@kcl.ac.uk with any technical queries.
  3. When any measure is used and is cited in any publication, the full reference to the key paper describing the scale must be included in the footer.
  4. Do not pass the scale on to a third party (instead please direct them to the website).

For translations:

  1. Translations into different languages should be done using Back Translation (as detailed in the Translation Guidelines).
  2. Include the copyright information in the footer of the scale.
  3. Any translated versions(s) must be made available to others who wish to use them. Send your translated versions to Maria Milenova (maria.milenova@kcl.ac.uk) and Dr Sara Evans-Lacko (sara.evans-lacko@kcl.ac.uk)
  4. No financial charge may be made for your version of our scales.

Measures relating to Stigma and Discrimination

Countries where the INDIGO Scales have been used (2013-2018)

The scales held on this website are:

BACE (Barriers to Accessing Care Evaluation) Translations into Cantonese, Italian, Kannada, Spanish, Portuguese and Telegu

The BACE measures barriers to accessing mental health care. It asks about 30 different barriers to care, and has a special focus on stigma-related barriers. It has a ‘treatment stigma’ subscale to assess to what extent the stigma associated with mental health care has been a barrier for an individual. It has good psychometric properties and is also being used in several studies around the world. Read this description in another language.

CODA (Costs of Discrimination Assessment)

The CODA has been developed to measure the economic costs than can arise due to the stigma and discrimination which people with mental health problems often face. The content of the CODA was based on a systematic review of the topic and on focus groups. The main sections of the CODA cover employment, health care use and avoidance, and leisure activities.

DISC (Discrimination and Stigma Scale) Translations into Swedish, Traditional Chinese, Arabic, Amharic, Tamil, Urdu, Turkish, Polish, Spanish

The DISC is an interview-based scale which measures experiences of mental health-related discrimination (‘being treated unfairly’) in key areas of everyday life and social participation, including work, marriage, parenting, housing, leisure, and religious activities. It has 21 questions. The DISC is designed to be completed by people who have experience of mental health problems. It is a reliable and valid measure and has been in over 40 countries around the world. Read this description in another language.

MAKS (Mental Illness Knowledge Scale) Translations into Arabic, Czech, Cantonese, French, Japanese, Kannada and Swedish

MAKS has been developed to measure mental health-related knowledge. The tool assesses and tracks stigma-related mental health knowledge among the general public and can be used to evaluate anti-stigma interventions. If used in combination with other assessment tools that measure attitudes and behaviour, MAKS can help researchers plan and develop interventions that effectively reduce stigma. Read this description in another language.

MICAv2 and MICAv4 (Mental Illness: Clinicians’ Attitudes scale) Translations into Czech, French, German, Italian, Kannada, Spanish and Portuguese

The Mental Illness Clinicians’ Attitudes scale (MICA-2) was created for use with medical students. It was found to be reliable, valid and responsive to change. An amended version (MICA-4) was validated with a sample of nursing students and may be suitable for staff and students from a wide range of health professions. The MICA has 16 questions and has been widely used around the world. Read this description in another language.

QUAD (Questionnaire on Anticipated Discrimination) Translations into Polish and German

The QUAD is a new measure of anticipated discrimination. It asks people how much they personally anticipate experiencing mental health-related discrimination across 14 areas of life. The QUAD is intended for use with people who have a mental health problem. Our research showed that the QUAD is an understandable, reliable and valid questionnaire.

RIBS (Reported and Intended Behaviour Scales) Translations into Arabic, Cantonese, Dutch, Italian, Japanese, Kannada and Swedish

RIBS has been designed to assess and track mental health related behavioural discrimination among the general public. Several studies have demonstrated the significance and high prevalence of discrimination experienced by service users, emphasising the importance of assessing and documenting behavioural tends. Read this description in another language.