The Impact of Mental Illness Stigma on People Diagnosed With Schizophrenia: An Analysis of Factors Contributing to Black-White Disparities in Schizophrenia Outcomes
Abstract
Background: Schizophrenia spectrum and other psychotic disorders pose significant challenges and impairments, with Black individuals disproportionately affected by these conditions. Racial disparities in schizophrenia diagnosis, treatment, and outcomes are well-documented, yet the underlying mechanisms remain poorly understood. This study addresses the potential contribution of mental illness stigma to these disparities by examining its impact on treatment-seeking behavior, substance use as a means of aversive coping, and overall psychological wellbeing among Black people diagnosed with schizophrenia spectrum and other psychotic disorders (PDWS).Methods: Data from the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP), a cluster randomized control trial conducted from 2009 to 2012, were utilized. A total of 404 participants were enrolled from 34 outpatient community mental health centers across the United States. Mental illness stigma was assessed using the Stigma Self-Report Scale (SSRS), depressive symptoms were measured with the Calgary Depression Scale for Schizophrenia (CDSS), psychological wellbeing was evaluated using an abbreviated version of the Scales of Psychological Wellbeing (SPWB), and social support was assessed using the interpersonal relations subscale of the Heinrichs-Carpenter Quality of Life Scale (QLS). Frequency of outpatient service use, psychiatric hospitalizations, and substance use types were also documented. T-tests and longitudinal path analysis was employed to explore the relationships among variables, the potential role of social support in buffering the impact of stigma, and Black-White racial differences in support for the proposed model.Results: While some racial differences emerged, including more outpatient visits by Black PDWS and less substance use, stigma did not directly predict wellbeing in the overall sample. Surprisingly, there was support for a relationship between stigma and depression symptom severity among White participants but not among Black participants. Social support did not significantly moderate the relationship between stigma and depression, although the moderation effect approached significance among Black participants. Model fit was equivalent across racial groups.Conclusion: This study underscores the importance of addressing stigma in interventions for PDWS, emphasizing its association with depression and substance use. It highlights the need for culturally sensitive, stigma-focused interventions tailored to the diverse experiences and needs of PDWS. Future research should further explore the complex interplay of stigma, depression, service utilization, substance use, social support, and race in shaping mental health outcomes among PDWS, with a focus on understanding and addressing racial disparities in schizophrenia diagnosis and treatment.
Subject Area
Clinical psychology|Psychology|Black studies|Mental health
Recommended Citation
Anakwenze, Obianujunwa, "The Impact of Mental Illness Stigma on People Diagnosed With Schizophrenia: An Analysis of Factors Contributing to Black-White Disparities in Schizophrenia Outcomes" (2023). ETD Collection for Fordham University. AAI30990324.
https://research.library.fordham.edu/dissertations/AAI30990324
