Background: Acculturation is one of the determinants of mental health among immigrants. Evaluating adaptation to the host culture is insufficient, since immigrants will develop various degrees of bi- or multicultural identity. However, mental health professionals lack simple and easy to use instruments to guide them with bicultural identity evaluation in their practice. Our aim was to develop such an instrument to be used for clinical purposes among economical migrants from three South European countries living in Geneva, Switzerland. Methods: We adapted from existing instruments a 24 item bi-dimensional scale to assess involvement in both culture of origin and host culture. The study included 93 immigrant adults from three south European countries (Italy, Portugal and Spain). Thirty-eight patients were recruited in an outpatient treatment program for alcohol-related problems and 55 participants were hospital employees. Results: The questionnaire was rated as easy or rather easy by 97.8% of participants. Median time to complete it was 5 minutes. The instrument allowed discriminating between patients and healthy subjects, with scores for Swiss culture significantly higher among hospital workers. The subscales related to culture of origin and host culture displayed adequate internal consistency (Cronbach's alpha 0.77 and 0.73 respectively). Conclusion: It is possible to assist clinicians' assessment of cultural identity of Italian, Portuguese and Spanish economical immigrants in Switzerland with a single and easy to use instrument. © 2007 Eytan et al; licensee BioMed Central Ltd.

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