Mediating Effect of Social Participation on the Experience of Discrimination and Self-Acceptance of Disability Among People With Mental Illness

PURPOSE: People with mental illness experience more discrimination than who have other type of disabilities. The discrimination experiences lead people with mental illness to poor self-acceptance of disability and social isolation. Social participation, the factor that assessed social isolation, is that individuals in various activities within their communities. It is important in that it allows them to accept their disability more positively (Barham & Hayward, 1998). However, most of studies have been conducted on people with physical disabilities, and no studies have yet demonstrated the relationship between discrimination experience, social participation, and self-acceptance of disability in people with mental illness. Therefore, this study aimed to investigate a mediating effect of social participation between discrimination experience and self-acceptance of disability within people with mental illness.

DESIGN: This study was a cross-sectional secondary research design. The 2020 Fifth Panel Survey of Employ for the Disables (PSED), a data set used for analysis, targets on community-dwelling people with disabilities aged from 15 to 64 in Korea (Lim et al., 2021). In this study, among the people participated in the survey only those who diagnosed with mental illness (e.g., schizophrenia, bipolar disorder, schizoaffective disorder, recurrent depressive disorder) were selected.

METHOD: A total of 135 people with mental illness were selected from the data set. Their response about discrimination experiences, self-acceptance of disability, and social participation were used for analysis. The level of discrimination experience and social participation was assessed by the question consisting of a 4-point Likert scale. The questions of self-acceptance were included 9-items of disability awareness and 3-item of overcoming disability. Each item was a 5-point Likert scale. The sum of the score of each item was used for self-acceptance of disability total score. The path modeling was conducted to demonstrate the relationships between key variables. Through bootstrap method, the 95% confidence interval (CI) and statistical significance of the indirect effects was calculated from 5000 bootstrap resamples. Result: The indirect effect from discrimination experiences to self-acceptance of disability was statistically significant (95% CI = -.934∼-.095, p = .049), while the direct effect was not (Estimate = -.883, p = .176). Both direct paths from discrimination experiences to social participation (Estimate = -.159, p = .019) and from social participation to self-acceptance of disability (Estimate = 2.516, p < .000) were significant. This result was indicated that social participation acts as full mediating variable between the other two variables within this data.

CONCLUSIONS: Through this study, we found that social participation is an important factor in the mechanism of people with mental illness between discrimination experiences and self-acceptance of disability. Social participation is also the main area consisting of the occupation, so the regard of occupational therapists is needed (American Occupational Therapy Association [AOTA], 2020). To counteract the negative influence of discrimination experiences, social participation needs to be considered as the main goal of intervention for people with mental illness.

References

Barham, P. & Hayward, R. (1998). “In sickness and in health: Dilemmas of the person with severe mental illness”. Psychiatry, 61(2), 163-170. https://doi.org/10.1080/00332747.1998.11024826

Lim, Y., Kim, H., Jang, S., Jeon, Y., Kim, E., Choi, J., & Park, S. (2021). 2020 panel survey of employ for the disables (Second wave, fifth survey). Retrieved from https://edi.kead.or.kr/BoardType01.do?bid = 20&mid = 38&cmd = _view&idx = 17498&currentPage = 1&searchYear = 0&searchField = 0&searchString =

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001