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

Epidemiol Psychiatr Sci. 2019 Aug;28(4):458-465. doi: 10.1017/S2045796018000021. Epub 2018 Jan 31.


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.

MeSH terms

  • Adult
  • Emotions / physiology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Involuntary Treatment*
  • Male
  • Mental Disorders / complications
  • Mental Disorders / psychology
  • Mental Disorders / rehabilitation*
  • Outcome Assessment, Health Care
  • Psychiatric Status Rating Scales
  • Self Concept
  • Shame*
  • Social Stigma*
  • Stereotyping*
  • Stress, Psychological / etiology*
  • Stress, Psychological / psychology
  • Switzerland
  • Young Adult