Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong

Abstract

Background: Self-stigma exerts a range of adversities for persons with severe mental illness (SMI), however, little is known about the association between peer contact, social support and self-stigma. Aims: This study aimed to explore the mediating role of social support on the relationship between peer contact and self-stigma among persons with SMI in Hong Kong. Methods: A total of 159 persons with SMI (schizophrenia and mood disorder) in community service centres participated in the study through completing a survey on self-stigma, social functioning, social support, perception of peer contact and mass media. Logistic regression was utilised to explore the influencing factors of self-stigma among the participants. Results: The results showed that 81.1% of participants reported moderate to severe levels of self-stigma. Self-stigma was significantly associated with diverse factors (e.g. social functioning). Importantly, positive peer contact was significantly associated with lower self-stigma of persons with SMI. Social support acted as a mediator between peer contact and self-stigma. Conclusion: The results of this study suggest that contact-based interventions, such as enhancing positive peer-to-peer contact, should be conducted for reducing self-stigma among persons with SMI.

The mediating role of knowledge on the contact and stigma of mental illness in Hong Kong

“…The focus of contact program, thus, could not only be on increasing the frequency of contact in different social systems and strengthening the favorable aspect of contact, but also consider local context to tailor the intervention. The results of this study also support that the enhancing contact model (ECM) on increasing the amount and positive level of contact should be crucial to reduce prejudice and social distance (Li et al, 2020). In addition, as our findings show, behavioral change toward more social acceptance and less discrimination is not affected by the extent of mental health knowledge.…”

“…Given the deleterious barriers that stigma poses on the recovery of PMI, a considerable body of research has found contact-based anti-stigma interventions to be a more effective strategy compared to protest and education (Evans-Lacko et al, 2012; Griffiths et al, 2014; Li et al, 2020; Mehta et al, 2015; Thornicroft et al, 2016). Allport (1954) formulated intergroup contact theory postulating that prejudice could be reduced when cross-group contact occurs within four conditions, including equal status, common goals, cooperation, and authority support.…”

“…In addition to these components, intimacy level of contact, voluntary nature of the contact, and perception that the contact experience is friendly were found to be additional factors promoting intergroup understanding (Desforges et al, 1991). While contact-based approaches were originally applied in reducing discrimination among ethnic and racial groups (Pettigrew, 1998), these strategies have been expanded to other stigmatized groups in recent years, including PMI (Corrigan et al, 2014; Li et al, 2020; London & Evans-Lacko, 2010). Evidence suggested that direct or face-to-face contact with PMI was likely to diminish stigmatizing attitudes including negative affective and behavioral responses (Couture & Penn, 2003).…”

“…Accordingly, the presence of ICCMW in high-density neighborhoods may promote contact between PMI and community residents. Recent research in Hong Kong has further signaled the important role that positive contact played in reducing stigma of mental illness (Chen et al, 2016; Fung et al, 2016; Li et al, 2020). An earlier study, however, found that experience of interaction with PMI were not linked to less stigmatizing attitudes (Callaghan et al, 1997) but the study was conducted before the implementation of ICCMW program.…”

Exorcising memories of internalised stigma: The demons of lived experience

“…Anti-stigma campaigns need to balance wide and broad approaches that seek to challenge discrimination in a large population of people with more local campaigns which focus on challenging the opinions of small groups[ 26 ]. This finding is reinforced by another study[ 27 ] which suggests that such strategies could be developed to also reduce self-stigma in people experiencing mental health issues. However, little is known about what elements of contact are effective in challenging stigma[ 10 ]; for example, is it equal status or promoting understanding about experiences of mental ill-health that makes contact-based strategies effective?…”