The Role of Internalized Stigma in Modulating Hope, Self-Esteem, and Self-Efficacy among Outpatients with Mental Illness

Abstract

Background: Mental health disorders influence emotions and behavior and frequently result in stigma, particularly personal stigma, where affected individuals internalize societal biases. This study explores the relationship between internalized stigma and hope, self-esteem, and self-efficacy in individuals with mental illness. Objectives: The aim was to investigate the relationship between internalized stigma and hope, self-esteem, and self-efficacy in patients with mental illness and to contribute to the discourse on mental health care. Methods: A cross-sectional study involving 126 mental illness outpatients from Amirkabir Hospital in Arak, Iran, was conducted. Instruments such as the Internalized Stigma Of Mental Illness (ISMI) Scale, Schneider's Dispositional Hope Scale, Rosenberg's Self-Esteem Scale, and the General Self-Efficacy Scale were utilized. Data were analyzed using statistical methods. Results: In this study of 126 participants (54% women, 46% men; ages ranging from 18 to 89), the average score for internalized stigma was 61.04 ± 18.37. There were significant negative correlations observed between self-stigma and hope (r = -0.658, P < 0.001), self-esteem (r = -0.666, P < 0.001), and self-efficacy (r = -0.641, P < 0.001). No significant relationships were identified with socio-demographic factors such as age, gender, and marital status. However, a significant relationship was observed between education level, self-stigma, and self-efficacy. Conclusions: The study confirms that internalized stigma significantly affects hope, self-esteem, and self-efficacy in patients with mental disorders. The findings emphasize the necessity for improved psychological services and educational programs to strengthen these factors, thus diminishing the impact of stigma and enhancing patients' lives.