Internalized Stigma of Mental Illness Scale

What it measures

The scale measures the degree to which people living with mental illness have internalized stigmatizing beliefs about themselves — including feeling alienated, endorsing negative stereotypes about people with mental illness, perceiving discrimination, and withdrawing socially as a result. A companion Stigma Resistance subscale captures the ability to reject or push back against these internalized beliefs, making the measure useful for tracking both the harm of stigma and resilience against it.

Response format

Likert (1–4, strongly disagree to strongly agree)

Representative items

• I feel out of place in the world because I have a mental illness. (Alienation)
• Mentally ill people tend to be violent. (Stereotype Endorsement)
• People discriminate against me because I have a mental illness. (Discrimination)
• I don't talk about myself much because I don't want to burden others with my mental illness. (Social Withdrawal)
• Living with mental illness has made me a stronger person. (R, Stigma Resistance)

Usage notes & scoring

Freely available from Jennifer Boyd Ritsher. Four stigma subscales and a Stigma Resistance subscale. Higher total score (excluding Stigma Resistance) = greater internalised stigma. Widely used in recovery-oriented research and anti-stigma intervention evaluation. ISMI-10 brief version available.

Recommended companion scales

Citation

Ritsher, J.B., Otilingam, P.G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121(1), 31–49.

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