Mental illnesses are prevalent and impairing conditions in the United States, with a 26% 12-month prevalence, and a 46% lifetime prevalence (Kessler, Chiu, Demler, & Walters, 2005; Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2005). In the United States, 5.8% of the population is considered as having a serious mental illness (SMI). The term SMI is used in federal regulations that refer to disorders that interfere with at least one area of social functioning. Mental illnesses are often stigmatized by the public and generally this stigma is regarded as an issue of concern, but the research indicates an inconsistent relationship between the presence of stigma and mental health (Mak, Poon, Pun & Chung, 2007). Given that stigma is both a social issue and a psychological issue, pitting in-groups against out-groups, it is often addressed in psychosocial treatment groups. The current study sought to generate a grounded theory model of stigma experiences and therapeutic changes experienced by those participating in a recovery-focused, psychoeducational group treatment program for persons with SMI, the Wellness Management and Recovery (WMR) program.
Qualitative data were collected from 12 participants of the WMR program. Two higher order themes emerged. The first theme regarded participant experiences with mental illness and stigma, while the second theme regarded their responses to these phenomena. These two themes, experiences and response to mental illness and stigma, provide a unique viewpoint on the relationships between mental illness, public stigma, and internalized stigma from the perspective of WMR participants. Subordinate themes including benefits, limitations, coping, and disclosure of mental illness are described by participants, as well as the role of WMR in promoting mental health recovery and lessening internalized stigma. Participants also reflected on their experience and put forth hypotheses for the development, persistence, and consequences of both public and internalized stigma. Finally, participants provided suggestions for reducing stigma in the general public.
Results of this study help to elucidate the complicated associations between symptoms of mental illness, coping, and how public and internalized stigma complicate the recovery process. Further support is provided for theories of stigma as a harmful social process with dire consequences for the internal and external environments of the stigmatized individual (Corrigan, 2004).