title: The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community.
abstract: OBJECTIVE
  For people with schizophrenia living in the community and receiving outpatient care, the issues of stigma and discrimination and dearth of recovery-oriented services remain barriers to recovery and community integration. The experience of self-stigma and unmet recovery needs can occur regardless of symptom status or disease process, reducing life satisfaction and disrupting overall well-being. The present study examined the mediating role of self-stigma and unmet needs in the relationship between psychiatric symptom severity and subjective quality of life.
  
  
  METHODS
  Structural equation modeling and mediation analyses were conducted based on a community sample of 400 mental health consumers with schizophrenia spectrum disorders in Hong Kong.
  
  
  RESULTS
  The model of self-stigma and unmet needs as mediators between symptom severity and subjective quality of life had good fit to the data (GFI = .93, CFI = .93, NNFI = .92, RMSEA = .06, χ(2)/df ratio = 2.62). A higher level of symptom severity was significantly associated with increased self-stigma (R (2) = .24) and a greater number of unmet needs (R (2) = .53). Self-stigma and unmet needs were in turn negatively related to subjective quality of life (R (2) = .45).
  
  
  CONCLUSIONS
  It is essential that service providers and administrators make greater efforts to eliminate or reduce self-stigma and unmet recovery needs, which are associated with the betterment of the overall quality of life and long-term recovery. Both incorporating empowerment and advocacy-based interventions into recovery-oriented services and providing community-based, person-centered services to people based on personally defined needs are important directions for future recovery-oriented efforts.
authors.affiliation: Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, Tai Po, Hong Kong.
authors.forename: Kevin K S
authors.initials: KK
authors.lastname: Chan
authors.forename: Winnie W S
authors.initials: WW
authors.lastname: Mak
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006301:Health Services Needs and Demand; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012649:Self Concept; D057545:Social Stigma; D011795:Surveys and Questionnaires
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