Perceived stigma and community integration among clients of assertive community treatment

Facilitating the integration of persons with psychiatric disabilities is an important goal of community programs. In addition to limitations such as inadequate housing, poverty, and unemployment, a common barrier to community adjustment identified by people with psychiatric disabilities is their perception of being stigmatized. This study examined the relationships between perceived stigma and community integration in 95 clients of assertive community treatment (ACT) teams, using sequential multiple regression procedures. Findings indicate that despite their physical presence in the community and the intensive support they receive, ACT clients believe other community members will reject them. Moreover, this perception appears to interfere with their sense of belonging, particularly among those who also perceive less social support and who have greater psychosocial skill deficits. In the context of the present study, global self-esteem did not mediate this relationship. In addition to community focused antistigma campaigns, stigma-related issues should also be addressed with ACT clients themselves.