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Epidemiol Psychiatr Sci. 2019 Aug;28(4):458-465. doi: 10.1017/S2045796018000021. Epub 2018 Jan 31.

Involuntary psychiatric hospitalisation, stigma stress and recovery: a 2-year study.

Author information

1
Department of Psychiatry II,University of Ulm and BKH Günzburg,Ulm,Germany.
2
Department of Psychiatry, Psychotherapy and Psychosomatics,Zürich University Hospital of Psychiatry,Zurich,Switzerland.
3
Institute of Epidemiology and Medical Biometry, University of Ulm,Ulm,Germany.

Abstract

AIMS:

Compulsory admission can be experienced as devaluing and stigmatising by people with mental illness. Emotional reactions to involuntary hospitalisation and stigma-related stress may affect recovery, but longitudinal data are lacking. We, therefore, examined the impact of stigma-related emotional reactions and stigma stress on recovery over a 2-year period.

METHOD:

Shame and self-contempt as emotional reactions to involuntary hospitalisation, stigma stress, self-stigma and empowerment, as well as recovery were assessed among 186 individuals with serious mental illness and a history of recent involuntary hospitalisation.

RESULTS:

More shame, self-contempt and stigma stress at baseline were correlated with increased self-stigma and reduced empowerment after 1 year. More stigma stress at baseline was associated with poor recovery after 2 years. In a longitudinal path analysis more stigma stress at baseline predicted poorer recovery after 2 years, mediated by decreased empowerment after 1 year, controlling for age, gender, symptoms and recovery at baseline.

CONCLUSION:

Stigma stress may have a lasting detrimental effect on recovery among people with mental illness and a history of involuntary hospitalisation. Anti-stigma interventions that reduce stigma stress and programs that enhance empowerment could improve recovery. Future research should test the effect of such interventions on recovery.

KEYWORDS:

Coercion; compulsory admission; empowerment; recovery; stigma stress

PMID:
29382403
DOI:
10.1017/S2045796018000021

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