Exploring the Impact of Stigma, Service Satisfaction, and Social Support on the Quality of Life of People with Mental Illness: A Qualitative Study

Background: This paper reports qualitative findings from a large mixed-methods project conducted in Gondar Hospital, Ethiopia. The results of a linked quantitative study showed that people with mental illness tended to enjoy a higher quality of life (QoL) when stigma is minimised, services are adequate, and social support is available. These elements create an environment of acceptance, safety, and support. However, the relationship between QoL, stigma, service satisfaction, and social support are complex and multifaceted, and there are very limited qualitative studies exploring the interactions among these factors to improve the QoL for people with mental illness. This study further explores these associations. Methods : A qualitative approach was employed, utilizing a semi-structured data-collection interview guide. Data were gathered through face-to-face in-depth interviews with twenty patients receiving follow-up care at the outpatient clinic at the University of Gondor Hospital outpatient clinic. Participants were selected through purposive sampling, considering factors such as gender, mental illness diagnosis, age, and duration of illness. The data were analysed using thematic analysis techniques. Results: The study identified seven themes in relation to the impacts of stigma, social support and satisfaction with health care service on QoL. These included Patient satisfaction with QoL, Stereotyped attitudes about mentally ill patients; internalised sense of shame/self-discrimination; practical and emotional support and assistance to remain on treatment; experiences of formal clinical care and impacts on symptom management; support in other aspects of life/ social connections and confidence; experiences of traditional and religious treatment .These findings revealed previously unexplored factors that influence QoL. Conclusions : This study provides evidence that multiple dimensions can influence the QoL for individuals with mental illness, particularly concerning stigma, service satisfaction, and social support. These findings may assist policymakers, researchers, and clinicians in developing intervention strategies aimed at enhancing the QoL for people with mental illness. Furthermore, the results underline the need for larger-scale studies to further investigate these factors.