The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community
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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.
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.
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 (R2 = .24) and a greater number of unmet needs (R2 = .53). Self-stigma and unmet needs were in turn negatively related to subjective quality of life (R2 = .45).
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.