The influence of Stigma, Disclosure, and Self-Esteem on Quality of Life in Individuals with Mental Illness

Introduction Stigma not only influences the willingness to disclose mental health conditions and self-esteem but may also diminish the overall quality of life in individuals with mental illnesses. However, limited research has examined the potential mechanisms underlying this complex relationship. Objectives This study aims to explore the mediating roles of disclosure and self-esteem in the association between mental illness stigma and quality of life. Methods We utilized the meta-analytic structural equation modeling (MASEM) approach and conducted a comprehensive literature search across various electronic databases to identify relevant publications up to July 2023. MASEM was employed to derive bivariate correlation matrices for stigma, disclosure, self-esteem, and quality of life. Additionally, two simple mediation models and one serial mediation model were tested to examine the relationships between these variables. Results The analysis included 181 articles reporting 195 independent samples (N = 33,162) and 278 effect sizes. The single mediator model indicated that self-esteem (β = −0.155, 95% CI [−0.276, −0.070], p < .001), rather than disclosure (β = −0.019, 95% CI [−0.094, 0.031], p > .05), served as a mediator. In the multiple mediator model, disclosure and self-esteem were found to have serial mediating roles between stigma and quality of life (β = −0.016, 95% CI [−0.0546, −0.0003], p < .05). Conclusions This study makes a significant contribution to understanding how stigma attitudes impact the quality of life in individuals with mental health problems, providing a strong empirical foundation for the development of mental health interventions. Future research directions and practical implications are also explored. Disclosure of Interest None Declared