Revisiting the relationships among community mental health services, stigma, and well-being.

Methodology/approach 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).

 

Findings 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.

 

Research limitations/implications 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.

 

Originality/value 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.