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. 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

Z Xu  1 , B Lay  2 , N Oexle  1 , T Drack  2 , M Bleiker  2 , S Lengler  2 , C Blank  2 , M Müller  2 , B Mayer  3 , W Rössler  2 , N Rüsch  1
Affiliations

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

Z Xu et al. Epidemiol Psychiatr Sci. 2019 Aug.

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.

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Figures

Fig. 1.
Fig. 1.
Stigma stress and emotional reactions to involuntary hospitalisation as predictors of recovery after 2 years, controlling for baseline levels of all three dependent variables as well as for age, gender, symptoms and intervention status. Standardised path coefficients and Full Information Maximum Likelihood in Mplus (n = 131). For results of the same model with imputed data (n = 186) see Online Figure 1. *p < 0.05, **p < 0.01, ***p < 0.001, +p = 0.08.
See this image and copyright information in PMC

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