The Weight of Stigma: Oppressed People and Mental Health Stigma

Katherine [Katu] Medina-Pineda, MHC-LP

Mental health stigma is a public health crisis as it impacts all individuals; however, the people who bear the brunt of this stigma are those whose identities and experiences are marginalized and minoritized. Stigma surrounding mental illness and mental health services doesn’t operate in a vacuum. It intersects with racism, sexism, homophobia, ableism, classism, and other forms of oppression, creating a toxic environment that damages the mental health of those already navigating systems created to oppress them. When we examine how stigma affects marginalized groups, it becomes clear that addressing mental health disparities requires dismantling the stigma at both interpersonal and structural levels.

Stigma as a Structural Force

Historical abuses in research and healthcare shape how marginalized communities interact with mental health systems. From the Tuskegee syphilis study to forced sterilizations and unethical psychiatric experiments (all of which were done primarily if not exclusively on Black people), there’s a deep-rooted mistrust that cannot be ignored. This legacy continues to inform how individuals from marginalized groups perceive and experience stigma, including fears of being pathologized or exploited if they seek help.

The US Department of Labor defines structural stigma as “punitive or discriminatory laws, policies, and practices that negatively affect the stigmatized group”-- a definition that, while limited, helps shine a light on how the laws and policies in place are rooted in white supremacy. Stigma is not merely a set of negative stereotypes. It is embedded in policies, institutions, and cultural narratives that define who/what is valued and who is marginalized. This form of stigma restricts access to mental health care, education, housing, and employment — all of which are critical to psychological well-being.

For example, research shows that BIPOC- who are minoritized and not the minority- often receive lower-quality mental health care and are more likely to face barriers such as language access, cost, and culturally insensitive providers. These systemic issues are not just logistical obstacles; they are manifestations of stigma that convey the message that these communities’ mental health does not matter.

Internalized and Community-Level Stigma

The damage doesn't stop at policy. Structural stigma seeps into community dynamics, creating within-group hierarchies that mirror broader societal biases. According to Misra, S., et al. (2021), BIPOC may internalize eurocentric beauty standards, leading to colorism, texturism, and fatphobia that negatively affects those with darker skin tones — a form of intra-community stigma that has real psychological consequences.

Similarly, individuals in marginalized communities may internalize stigma related to mental health, viewing it as a personal failing rather than a legitimate health issue. This internalized stigma leads to shame, isolation, and reluctance to seek help. In Misra, S., et al. (2021) systematic review of stigma among Asian, Black, and Latinx Americans, researchers found that self-stigma, fear of burdening family, and emotional suppression were common and culturally reinforced. A study conducted by Frost and Castro published in 2024 found that living under the constant threat of being judged, rejected, or discriminated against because of both one's identity and mental health status results in chronic stress. This is often referred to as “stigma-related stress,” and it can manifest through experiences like microaggressions, expectations of rejection, or internalized devaluation of one’s identity.

Coping mechanisms to systemic stress such as rumination, hypervigilance, and emotional suppression paired with individual and community stigma exacerbates adverse mental health outcomes in marginalized people. These responses not only increase the likelihood of developing depression and anxiety, but also erode a person’s ability to regulate emotions over time. For those navigating intersecting stigmatized identities — such as being both queer and disabled, or Black and low-income — these stressors are compounded.

Resistance, Resilience, and the Path Forward

Despite the weight of stigma, marginalized communities have developed powerful forms of resistance and resilience. Community connectedness, cultural pride, and collective healing practices serve as protective factors that buffer against the psychological toll of stigma (Frost & Castro, 2024). 

To reduce the mental health burden of stigma, interventions must go beyond awareness campaigns. They must address the structural roots of stigma — including inequities in access, provider bias, and cultural incompetence — while also validating and empowering the lived experiences of marginalized individuals. Cultural competence in mental health services, participatory research methods that avoid further stigmatization, and the inclusion of community voices are essential for this change.

Conclusion

Stigma toward mental illness is not evenly distributed. For marginalized communities, it is deeply intertwined with histories of oppression, systemic inequality, and ongoing discrimination. To promote mental health equity, we must confront stigma not just as a personal attitude but as a structural barrier — one that harms, isolates, and dehumanizes. Only then can we begin to heal the wounds it leaves behind.

Sources:

Frost, D. M., & Castro, D. (2024). An Integrated Understanding of the Mechanisms Linking Social Stigma to Mental Health Among Marginalized Populations.
Misra, S., et al. (2021). Systematic Review of Cultural Aspects of Stigma and Mental Illness Among Racial and Ethnic Minority Groups in the United States.
Gabbidon, K., & Chenneville, T. (2020). Strategies to Minimize Further Stigmatization of Communities Experiencing Stigma.
Mitchell, U. A., et al. (2021). The Long Arm of Oppression.