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The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community

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Abstract

Purpose

For people with schizophrenia living in the community and receiving outpatient care, the issues of stigma and discrimination and dearth of recovery-oriented services remain barriers to recovery and community integration. The experience of self-stigma and unmet recovery needs can occur regardless of symptom status or disease process, reducing life satisfaction and disrupting overall well-being. The present study examined the mediating role of self-stigma and unmet needs in the relationship between psychiatric symptom severity and subjective quality of life.

Methods

Structural equation modeling and mediation analyses were conducted based on a community sample of 400 mental health consumers with schizophrenia spectrum disorders in Hong Kong.

Results

The model of self-stigma and unmet needs as mediators between symptom severity and subjective quality of life had good fit to the data (GFI = .93, CFI = .93, NNFI = .92, RMSEA = .06, χ2/df ratio = 2.62). A higher level of symptom severity was significantly associated with increased self-stigma (R 2 = .24) and a greater number of unmet needs (R 2 = .53). Self-stigma and unmet needs were in turn negatively related to subjective quality of life (R 2 = .45).

Conclusions

It is essential that service providers and administrators make greater efforts to eliminate or reduce self-stigma and unmet recovery needs, which are associated with the betterment of the overall quality of life and long-term recovery. Both incorporating empowerment and advocacy-based interventions into recovery-oriented services and providing community-based, person-centered services to people based on personally defined needs are important directions for future recovery-oriented efforts.

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Acknowledgments

This study is supported by Research Grant 07080161 from the Health and Health Services Research Fund (HHSRF) of Hong Kong. We would like to express our sincere gratitude to the following nongovernmental organizations and mutual support group (in alphabetical order) for facilitating us in recruiting eligible participants from their service users/members: Amity Mutual Support Society; Baptist Oi Kwan Social Service; Christian Family Services; New Life Psychiatric Rehabilitation Association; and the Society of Rehabilitation and Crime Prevention.

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  1. Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, Tai Po, Hong Kong

    Kevin K. S. Chan

  2. Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong

    Winnie W. S. Mak

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Correspondence to Winnie W. S. Mak.

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Chan, K.K.S., Mak, W.W.S. The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community. Qual Life Res 23, 2559–2568 (2014). https://doi.org/10.1007/s11136-014-0695-7

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