The Unspoken Struggles from Mental Health Stigma in a Rural Community: A Qualitative Exploration of Clubhouse Members' Lived Experiences.

Rural communities have a close-knit social structure, hindering the disclosure of mental disorders due to fear of negative societal perception. The study aimed to explore the experiences of both clubhouse members and staff with stigma and to examine how the Clubhouse addresses stigma in rural Wyoming through semi-structured interviews. Semi-structured interviews were conducted with 16 participants (12 clubhouse members and 4 staff members). The data analysis was performed in NVivo using reflexive thematic analysis. Three main themes were generated: "mental health prejudices," where participants reported being perceived as dangerous, unintelligent, incompetent, and attention seekers. The second main theme, "the root causes of mental health stigma," has three subthemes: "mental health illiteracy", "the media," and "personal struggles and background." The third main theme, "clubhouse effort to address stigma," encompasses two subthemes: "the unique clubhouse environment for self-stigma recovery" and "advocacy and community outreach." The study findings highlight the emotional challenges individuals with mental illness face due to stigma from the media and the public. However, the clubhouse provides a non-judgmental environment that addresses both self- and public stigma. The findings also support expanding clubhouses, especially in rural areas, to improve mental health outcomes.