A Cross-Diagnostic Investigation of the Differential Impact of Discrimination on Clinical and Personal Recovery

• Published in: Psychiatric services (Washington, D.C.) Vol. 68; no. 2; pp. 159 - 166
• Main Authors: Mak, Winnie W. S, Chan, Randolph C. H, Wong, Samuel Y. S, Lau, Joseph T. F, Tang, Wai Kwong, Tang, Alan K. L, Chiang, Tin Po, Cheng, Sammy K. W, Chan, Fu, Cheung, Fanny M, Woo, Jean, Lee, Diana T. F
• Format: Journal Article
• Language: English
• Published: United States American Psychiatric Association 01.02.2017; American Psychiatric Publishing, Inc
• Subjects: Adult; Attitude of Health Personnel; Discrimination; Female; Hong Kong; Humans; Male; Medical diagnosis; Mental disorders; Mental health care; Mental Health Services; Middle Aged; Mood Disorders - psychology; Mood Disorders - therapy; Patient Compliance - psychology; Prejudice - psychology; Psychotic Disorders - psychology; Psychotic Disorders - therapy; Rehabilitation; Self Concept; Social Stigma; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Hong Kong China; China; Substance use disorders; Psychotic disorders; Discrimination; Self-stigma; Recovery
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/appi.ps.201500339

Objective:Although the negative association between discrimination and recovery has been established, only a few studies have attempted to investigate the underlying mechanism of how perceived discrimination dampens both clinical and personal recovery among people with psychiatric disorders. This study aimed to examine the mediating roles of self-stigma and mental health service engagement in the relationship between perceived discrimination and recovery.Methods:A total of 374 people (half men and half women; mean±SD age=43.47±12.76) living in Hong Kong and in recovery with a primary diagnosis of a psychotic disorder, mood disorder, or substance use disorder responded to a cross-sectional questionnaire on discrimination, self-stigma, mental health service adherence, recovery orientation of services, clinical recovery, and personal recovery. Multisample structural equation modeling was conducted to examine whether the hypothesized model for perceived discrimination and recovery produced results that could be generalized across people with various psychiatric diagnoses.Results:Findings indicated that respondents perceived discrimination from the general public and from health care professionals, which was positively associated with self-stigmatization and service disengagement and was negatively associated with clinical and personal recovery across three different types of psychiatric disorder.Conclusions:This study showed that the influence of perceived discrimination on recovery was universal and could be generalized across people with different psychiatric diagnoses. Multipronged stigma reduction interventions targeting the general public, health care professionals, and people in recovery, along with policies that avert discrimination and uphold human rights in health care settings and beyond, should be implemented.