Examining the Relationship between Internalized Stigma and Unmet Service Needs Among Individuals on Probation with Serious Mental Illness

Introduction: There are many individuals with serious mental illness on probation in the United States. Individuals on probation often face numerous barriers in accessing needed services such as housing, employment, and healthcare, with internalized stigma of mental illness potentially serving as one impediment. This study examined the relationship between internalized stigma and unmet service needs among those on probation with serious mental illness. Methods: Cross-sectional data from 50 individuals on specialty mental health probation were analyzed. Internalized stigma was measured using the Internalized Stigma of Mental Illness (ISMI) scale. Service needs and utilization were assessed across 12 domains. Independent t-tests and Poisson regressions controlling for demographics and diagnosis evaluated associations between ISMI levels and number of service needs and unmet needs. Results: 26% of participants had high internalized stigma. High stigma was not associated with overall greater service needs. However, Poisson regression indicated that after controlling for covariates, the high stigma group had 96.5% higher expected counts of unmet service needs compared to the low stigma group. Discussion: While high internalized stigma did not predict overall greater service needs, it was a significant predictor of a higher number of unmet needs, suggesting stigma creates barriers to receiving crucial support services for this population. Incorporating stigma reduction interventions alongside rehabilitative services, educating criminal justice personnel on mental illness, and increasing support for comprehensive reentry care may help address this issue.