School of Social Work, Boston College.
Department of Psychology, Harvard University.
J Clin Child Adolesc Psychol. 2022 Sep-Oct;51(5):810-825. doi: 10.1080/15374416.2022.2109652. Epub 2022 Aug 25.
Stigma refers to societally-deemed inferiority associated with a circumstance, behavior, status, or identity. It manifests internally, interpersonally, and structurally. Decades of research indicate that all forms of stigma are associated with heightened risk for mental health problems (e.g., depression, PTSD, suicidality) in stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities, such as youth of Color and transgender youth). Notably, studies find that stigmatized youth living in places with high structural stigma - defined as laws/policies and norms/attitudes that hurt stigmatized people - have a harder time accessing mental health treatment and are less able to benefit from it. In order to reduce youth mental health inequities, it is imperative for our field to better understand, and ultimately address, stigma at each of these levels. To facilitate this endeavor, we briefly review research on stigma and youth mental health treatment, with an emphasis on structural stigma, and present three future directions for research in this area: (1) directly addressing stigma in treatment, (2) training therapists in culturally responsive care, and (3) structural interventions. We conclude with recommendations for best practices in broader mental health treatment research.
污名是指与一种情况、行为、地位或身份相关的社会认定的劣等感。它表现在内部、人际间和结构上。几十年来的研究表明,所有形式的污名都与被污名化的年轻人(即有色人种青年和跨性别青年等有一个或多个被污名化身份的儿童、青少年和年轻人)的心理健康问题(例如抑郁、创伤后应激障碍、自杀倾向)风险增加有关。值得注意的是,研究发现,生活在结构性污名高的地方的被污名化的年轻人——定义为伤害被污名化的人的法律/政策和规范/态度——更难获得心理健康治疗,也更难从中受益。为了减少青年心理健康方面的不平等,我们领域必须更好地理解并最终解决这些层面的污名问题。为了促进这一努力,我们简要回顾了关于污名和青年心理健康治疗的研究,重点是结构性污名,并提出了该领域研究的三个未来方向:(1)在治疗中直接解决污名问题,(2)培训治疗师进行文化上响应的护理,以及(3)结构性干预。我们最后为更广泛的心理健康治疗研究提出了最佳实践建议。