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Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention

Year: 2025

Type: review

Abstract: Researchers, interventionists, and clinicians are increasingly recognizing the importance of structural stigma in elevating the risk of mental illnesses (MIs) and substance use disorders (SUDs) and in undermining MI/SUD treatment and recovery. Yet, the pathways through which structural stigma influences MI/SUD-related outcomes remain unclear. In this review, we aim to address this gap by summarizing scholarship on structural MI/SUD stigma and identifying pathways whereby structural stigma affects MI/SUD-related outcomes. We introduce a conceptual framework that describes how structural-level stigma mechanisms influence the MI/SUD treatment cascade via ( a ) interpersonal- and individual-level stigma mechanisms and ( b ) mediating processes among people with MI/SUD (i.e., access to resources, psychological responses, behavioral responses, social isolation). We consider intersections between MI/SUD stigma and stigma based on race/ethnicity, gender identity, and sexual orientation. Finally, we discuss the implications of this review for future research, interventions, and clinical practice.

Source: Annual Review of Clinical Psychology

DOI: 10.1146/annurev-clinpsy-081423-023228

Authors: Valerie A. Earnshaw, Mohammad Mousavi, Xueli Qiu, Annie B. Fox

Institutions: University of Delaware, MGH Institute of Health Professions, Massachusetts General Hospital

Language: English

Topic: Mental Health Treatment and Access

Subfield: Social Psychology

Field: Psychology

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: hybrid

OpenAlex ID: W4406321193

FWCI: 3.832

Cites: 132

Cited by: 16

Related to: 10