Internalized stigma among people with severe mental illness in rural China

Abstract

Objectives: To understand the stigma of mental illness in people with severe mental illness (SMI) in rural China Background and Aims: Although stigma of mental illness can prohibit accessing to health and social services for people with SMI, it is unknown about the internalized stigma among these people in rural China. This study aimed to explore the internalized stigma and its influencing factors among people with SMI in Chengdu China Materials and Methods: 453 people with schizophrenia (n=232), major depressive disorder (n=182), or bipolar disorder (n=39) in Xinjin, Chengdu participated in this study. Sociodemographic data, illness characteristics,internalized stigma of mental illness (ISMI),social support and social functioning were assessed. Results and Conclusions: The internalized stigma was moderate and severe with 94.7% of the total sample.The ISMI mean score ≥ 2.5 were found in persons with schizophrenia (48.3%), major depressive disorder (42.9%), and bipolar disorder (33.3%). Persons with schizophrenia had significantly higher mean scores of total ISMI, alienation and discrimination experience than those with bipolar disorder. Lower family income was significantly associated with higher levels of internalized stigma in persons with schizophrenia and major depressive disorder.A hierarchical regression model showed that social support and social functioning were factors influencing internalized stigma. This study shows that the internalized stigma is common and severe in persons with schizophrenia, major depressive disorder and bipolar disorder, especially those with lower income status in rural China. People with different type of SMI have different influencing factors of their internalized stigma. Cultural-specific interventions on reducing stigma should be conducted for people with SMI within the Chinese rural context.