Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention
Date
2025-01-13
Journal Title
Journal ISSN
Volume Title
Publisher
Annual Review of Clinical Psychology
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.
Description
This article was originally published in Annual Review of Clinical Psychology. The version of record is available at: https://doi.org/10.1146/annurev-clinpsy-081423-023228.
Copyright © 2025 by the author(s).
This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information.
Keywords
addiction, intersectionality, mental illness, substance use disorder, stigma, structural stigma
Citation
Earnshaw, Valerie A., Mohammad Mousavi, Xueli Qiu, and Annie B. Fox. “Mental Illness and Substance Use Disorder Stigma: Mapping Pathways Between Structures and Individuals to Accelerate Research and Intervention.” Annual Review of Clinical Psychology. Annual Reviews, 2025. https://doi.org/10.1146/annurev-clinpsy-081423-023228.