Interpersonal Stigma and Positive Experiences in Relationships for People Living With Schizophrenia Spectrum and Other Complex Disorders, With and Without Co-Occurring Substance Use Disorders

Hobern, Beth
Rehm, Imogen C.
Blanchard, Michelle
Groot, Christopher

Melbourne School of Psychological Sciences, The University of Melbourne
Anne Deveson Research Centre, SANE, Carlton, Victoria, Australia
Institute of Health and Sport, Victoria University

Kelly E. Moore served as action editor.

To protect the anonymity of the participants in this study, the data set used in this article is not available. Additional information and data from the Our Turn to Speak survey is available at https://nationalstigmareportcard.com.au/. The project was approved by the University of Melbourne Human Research Ethics Committee (HREC Project No. 1955446.2). Informed consent to participate was received from all participants.

The National Stigma Report Card project’s Our Turn to Speak survey was conducted in partnership between the Melbourne School of Psychological Sciences and SANE Australia’s Anne Deveson Research Centre, with funding support from the Paul Ramsay Foundation. Each of the authors has previously worked for or received financial support from SANE Australia through the National Stigma Report Card project. The present article reports secondary analyses of the “Our Turn to Speak” survey data which were conducted as part of Beth Hobern’s research within the National Stigma Report Card project. No specific funding was provided for this study, and the funder had no role in preparing this article.

Our positionality statements follow: Mindful that our identities can influence our approach to science (Roberts et al., 2020), the authors provide the reader with information about the backgrounds. With respect to gender, when the article was drafted, three authors self-identified as women and one author as a man. With respect to race, all four authors self-identified as White.

Beth Hobern played a lead role in conceptualization, data curation, formal analysis, methodology, writing–original draft, and writing–review and editing. Imogen C. Rehm played a supporting role in conceptualization, formal analysis, and methodology and an equal role in writing–review and editing. Michelle Blanchard played a supporting role in conceptualization and methodology and an equal role in writing–review and editing. Christopher Groot played a lead role in supervision, a supporting role in conceptualization, formal analysis, and methodology, and an equal role in writing–review and editing.

Beth Hobern, Melbourne School of Psychological Sciences, The University of Melbourne, 12th Floor Redmond Barry Building, Parkville, VIC 3052, Australia [email protected]

Received January 1, 2025

revised May 6, 2025

Accepted May 9, 2025

Stigma and Health Publish Ahead of Print, June 9, 2025. | DOI: 10.1037/sah0000650

Stigma in interpersonal relationships is a barrier to social engagement, recovery, and well-being for people living with complex mental health conditions. Among people living with these conditions, individuals who experience schizophrenia spectrum disorders (SZ) face particularly high levels of stigma. Many individuals living with complex mental health conditions experience co-occurring substance use disorders (SUD), which may compound the effects of interpersonal stigma. However, little research has examined stigma in interpersonal relationships for people living with co-occurring complex mental health conditions and SUD, including co-occurring SZ and SUD (SZSUD). This study analyzed qualitative data from 90 Australians living with SZ, SZSUD, and co-occurring SUD and complex mental health conditions other than SZ collected as part of the National Stigma Report Card’s Our Turn to Speak survey. A thematic analysis examined and compared perceived experiences of interpersonal stigma and positive treatment in relationships with friends, family members, and intimate partners between these groups. Four themes were identified: “social disconnection,” “negative and degrading judgements,” “loss of power and control,” and “the pillars of positive relationships.” While participants in all three groups described similar types of experiences in their relationships, certain experiences were only reported by people living with either SZ or SUD. In many cases, participants living with SZSUD described both types of experiences. These findings provide preliminary support for the theory that people who experience co-occurring complex and highly stigmatized conditions, such as SZSUD, face compounded stigma in interpersonal relationships due to the combined effects of stigma associated with each condition.

Open Access funding provided by The University of Melbourne: This work was licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0; https://creativecommons.org/licenses/by/4.0). This license permits copying and redistributing the work in any medium or format, as well as adapting the material for any purpose, even commercially.