Experiences of stigma and discrimination and their relationship with internalized stigma in individuals diagnosed with severe mental disorders in Gran Concepción, Chile

This qualitative study explored the relationship between experiences of stigma and discrimination, and internalized stigma in people with severe mental disorders residing in Gran Concepción, Chile. Twelve participants were selected from a secondary care health center through a maximum variation sampling. Data were collected using semi-structured in-depth interviews, followed by reflective thematic analysis. Responses addressed four themes: 1) perception of the diagnosis; 2) perception and experiences of stigmatization and discrimination; 3) self-perception and internalized stigma; and 4) work. Most participants conceptualized psychiatric diagnoses in negative terms and reported experiences of stigmatization in the family, school, community, work, and health environments. However, only those exposed to stigma in the health area described internalized stigma. This finding highlights the paradoxical role of health services, which, instead of functioning solely as spaces of support and treatment, may also become central settings for the development of internalized stigma, underscoring the need to critically review institutional and professional practices. The study suggests that experiences in the health services may be crucial for the development of internalized stigma.