Self-Stigma, Secrecy, and Disclosure Among Chinese with Serious Mental Illness

The self-stigma of mental illness can undermine self-esteem leading to greater depression. This study examines the impact of varied models of self-stigma on Chinese with serious mental illness. First, we validate a progressive model of self-stigma. Then, we examine the mediating effects of self-esteem on stigma harm and depression. Finally, we examine mediating effects of disclosure and secrecy on stigma harm and depression. One hundred thirty-five Chinese with serious mental illness completed measures of the four progressive stages of self-stigma, self-esteem, depression, disclosure-self-efficacy, and secrecy-self-efficacy. Findings of structural equation modeling supported the progressive model of self-stigma. Self-esteem was found to positively mediate stigma harm on depression. While secrecy seemed to have no effect on the self-stigma and self-esteem path, disclosure was found to positively mediate stigma harm on self-esteem. These findings have implications for the development of programs meant to diminish self-stigma.