Factorial Validity of the Twi Version of the Mental Health Continuum-Short Form and Prevalence of Mental Health in a Rural Ghanaian Sample

Positive mental health, and the validity of its assessment instruments, are largely unexplored in the Ghanaian context. This study examined the factor structure of the Twi version of the Mental Health Continuum-Short Form and explored the prevalence of positive mental health in a sample of rural Ghanaian adults (N = 444). A bifactor exploratory structural equation modelling (ESEM) model fit the data better than competing models (confirmatory factor analysis [CFA], bifactor CFA, and ESEM models). We found a high omega reliability coefficient for the general positive mental health factor (ω = .97) and marginal reliability scores for the emotional (ω = .51) and social well-being (ω = .57) subscales, but a low reliability score for the psychological well-being subscale (ω = .41). Findings support the existence of a general mental health factor, and confirm the underlying three-dimensional structure of mental health, but suggest that caution should be applied when interpreting subscale scores, especially for the psychological well-being subscale. Based on Keyes’s criteria for the categorical diagnosis of the presence of positive mental health, 25.5% of the sample were flourishing, with 74.5% functioning at suboptimal levels (31.1% languishing, 41.4% with moderate mental health) and may benefit from contextually relevant positive psychological interventions, which may also buffer against psychopathology.