[Empowering Persons With Mental Illness to Begin the Recovery Journey: An Example of Overcoming Internalized Stigma]

Internalized stigma is a significant obstacle encountered on the journey to recovery for persons with mental illness. Services provided through the empowerment model of care have been shown to be effective in overcoming this obstacle. However, the mental health care system in Taiwan continues to focus on providing care using the medical or rehabilitation model. In this article, the related consequences and psychological effect mechanism of internalized stigma in persons with mental illness are presented and evidence-based interventions for internalized stigma are demonstrated. Next, we share the clinical experiences to advocate for the use by professionals of the empowerment model. Self-efficacy and empowerment may mediate the psychological effects of internalized stigma on quality of life and depression, while social networks and peer support may buffer its negative consequences. Related evidence-based interventions include psycho-education, motivation enhancement, self-help or peer-delivered services, and cognitive behavioral model and goal-oriented skill training. Empowerment model services are based on scientific evidence that are practiced under the rubric of self-determination and constructed in supportive environments. When examining psychiatric symptoms in persons with mental illness, professionals may concurrently evaluate for issues related to internalized stigma and encourage those patients with internalized stigma to self-determine and participate in therapy. In psycho-education and skill training therapies, professionals may also apply the lived experiences of peers with recovery to identify and share important knowledge and life skills. When connecting patients to community resources, professionals should encourage stakeholders to help persons with mental illness put their decisions into practice.