An exploration of the effects of perceived stigma on the quality of healthcare experiences among patients with mental illnesses or substance use disorders

Abstract

Objectives: Few studies have quantitatively examined the association between perceived stigma (expectations of stigma) and quality of healthcare experience among patients with mental illnesses or substance use disorders. To address this gap in stigma research, this study has two empirical objectives: 1) to determine if patients with higher expectations of stigma are more likely to report a negative healthcare experience 2) to determine if the effects of expectations of stigma on quality of healthcare experiences vary depending on the types of healthcare settings. Methods: This study used a subset of the data from a 2022 national stigma survey. The purpose of the online survey was to capture stigma experiences in the Canadian healthcare system. We focused on individuals who self-identified as having a mental illness or substance use disorder. (n=1381) Perceived stigma and quality of healthcare experiences were measured using psychometrically tested scales. A binary logistic model was estimated to measure the association between the two variables. A likelihood ratio test was performed to determine if the effects of expectations of stigma on quality of healthcare experiences were different between physical and mental healthcare settings. Results: Individuals with moderate or high expectations of stigma were more likely to report a negative healthcare experience compared to those with no or low expectations. Level of education, types of diagnosis, internal wellbeing and stigmatization from family members influenced the association between expectations of stigma and quality of healthcare experience. The effects of perceived stigma on quality of healthcare experience were not significantly different between physical and mental healthcare settings. Conclusions: This study provided empirical evidence for the association between perceived stigma and quality of healthcare experience among patients with mental or substance use disorders. There is a need for developing more effective anti-stigma interventions to reduce mental-illness and substance-use related stigma and discrimination in the Canadian healthcare system.