Community participation and subjective perception of recovery and quality of life among people with serious mental illnesses: the mediating role of self-stigma.

PURPOSE: Community participation is believed to be positively associated with recovery experiences and quality of life for people with serious mental illnesses (PSMIs). However, the underlying mechanism remains unclear. This study examined the mediating effect of self-stigma on the relationship between community participation and personal recovery experiences and quality of life among PSMIs.

METHODS: Structural equation modeling and mediation analyses were conducted based on a community sample of 315 PSMIs in Beijing, China, who were surveyed using the Community Participation Domains Measure, Internalized Stigma of Mental Illness, Recovery Assessment Scale, Quality of Life Scale, and a demographic questionnaire. Most were in their middle age. About half were married, and half were females. Most participants got disability certificates.

RESULTS: The results indicate that community participation is directly associated with personal recovery of PSMIs (P < 0.01) and indirectly associated with personal recovery through the mediation of self-stigma (P < 0.01). Additionally, community participation does not have a direct effect on the quality of life of PSMIs but shows an indirect effect through the mediation of self-stigma (P < 0.01). The findings suggest that self-stigma mediates the relationship between community participation and both the subjective perception of recovery and quality of life.

CONCLUSION: The findings indicate that community participation for PSMIs should be enhanced. Tailored individual intervention services should be implemented to boost positive self-awareness and reduce self-stigma through active engagement in activities. Such participation has the potential to improve subjective experiences of recovery and overall quality of life.