TY - SER
KW - self-concept
KW - Quality of Life
KW - Perceived stigma
KW - mental health services
KW - internalized stigma
KW - functioning
AU - Perry B
AU - Marcussen K
AU - Ritter C
AB - <p><strong>Purpose </strong>This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.</p>

<div><strong>Methodology/approach </strong>Data for this chapter come from structured interviews and service data for 140 individuals with severe and persistent mental illnesses. We use structural equation modeling to examine the relationship between perceived and internalized stigma, as well as the relationships among stigma, self-concept (self-esteem and mastery), and well-being (quality of life and functioning).</div>

<div>&nbsp;</div>

<div><strong>Findings </strong>We find that case management is negatively related to quality of life and psychiatric services are positively related to functioning. Crisis services and assessment are associated with mastery in opposite directions. Internalized stigma is positively associated with self-esteem and mastery, and negatively associated with functioning. We do not find a relationship between services and stigma.</div>

<div>&nbsp;</div>

<div><strong>Research limitations/implications </strong>A limitation to this chapter is the sample size, which prohibits us from examining a full range of services and outcomes. Nonetheless, our findings provide information about how services and stigma impact well-being, and may be used as a starting point for considering strategies for improving services and reducing stigma. Future work should consider pairing outcomes with services to determine their effectiveness.</div>

<div>&nbsp;</div>

<div><strong>Originality/value </strong>This chapter builds on previous research that examines the relative effects of services and stigma among individuals in community health care by extending measures of both services and stigma, and by examining the relationship between them, in order to better determine their implications for self-concept and well-being.</div>

BT - 50 Years After Deinstitutionalization: Mental Illness in Contemporary Communities 
DO - 10.1108/amso10.1108/S1057-629020161710.1108/S1057-629020160000017007
LA - eng
M1 - Advances in Medical Sociology, 17
N2 - <p><strong>Purpose </strong>This chapter examines the effects of mental health services and stigma on changes in self-concept and well-being for individuals with SPMI.</p>

<div><strong>Methodology/approach </strong>Data for this chapter come from structured interviews and service data for 140 individuals with severe and persistent mental illnesses. We use structural equation modeling to examine the relationship between perceived and internalized stigma, as well as the relationships among stigma, self-concept (self-esteem and mastery), and well-being (quality of life and functioning).</div>

<div>&nbsp;</div>

<div><strong>Findings </strong>We find that case management is negatively related to quality of life and psychiatric services are positively related to functioning. Crisis services and assessment are associated with mastery in opposite directions. Internalized stigma is positively associated with self-esteem and mastery, and negatively associated with functioning. We do not find a relationship between services and stigma.</div>

<div>&nbsp;</div>

<div><strong>Research limitations/implications </strong>A limitation to this chapter is the sample size, which prohibits us from examining a full range of services and outcomes. Nonetheless, our findings provide information about how services and stigma impact well-being, and may be used as a starting point for considering strategies for improving services and reducing stigma. Future work should consider pairing outcomes with services to determine their effectiveness.</div>

<div>&nbsp;</div>

<div><strong>Originality/value </strong>This chapter builds on previous research that examines the relative effects of services and stigma among individuals in community health care by extending measures of both services and stigma, and by examining the relationship between them, in order to better determine their implications for self-concept and well-being.</div>

PB - Emerald Group Publishing Limited
PY - 2016
SN - 978-1-78560-403-4/1057-6290
SP - 177
EP - 206
T2 - 50 Years After Deinstitutionalization: Mental Illness in Contemporary Communities 
TI - Revisiting the relationships among community mental health services, stigma, and well-being. 
UR - http://www.emeraldinsight.com/series/amsohttp://www.emeraldinsight.com/doi/book/10.1108/S1057-6290201617http://www.emeraldinsight.com/doi/10.1108/S1057-629020160000017007
ER -