When Stigma Strikes, Who Bears the Weight? Social Pathways to Psychological Distress in Carers of People With Severe Mental Illness: A Cross-Sectional Study.

INTRODUCTION: Social networks, social support and social isolation are potential pathways through which perceived social stigma links to psychological distress. Yet little is known about this in carers of people with severe mental illness. AIM: To assess the multiple pathways of social networks, social support and social isolation in the relationship between perceived social stigma and psychological distress among carers of people with severe mental illness. METHOD: 328 Chinese carers of people with severe mental illness were recruited in Hunan China. Participants completed the Perceived Devaluation-Discrimination Scale, Lubben Social Networks Scale, Multidimensional Scale of Perceived Social Support, Friendship Scale and Kessler 10 Scale between March and December 2023. Descriptive statistics, correlations and mediation analysis were applied. RESULTS: Social networks, social support and social isolation formed three pathways between perceived social stigma and psychological distress. DISCUSSION: Perceived social stigma affects the quantity and quality of social relationships, leading to social isolation, which serves as a critical component linking social stigma to psychological distress. IMPLICATIONS: Mental health practitioners and policymakers should recognise the pivotal role of social factors in carers' psychological wellbeing. Interventions aimed at strengthening social networks and social support, while reducing social isolation, may help alleviate psychological distress in carers.