Structural stigma: Research evidence and implications for psychological science.
Open accessAbstract
Psychological research has provided essential insights into how stigma operates to disadvantage those who are targeted by it. At the same time, stigma research has been criticized for being too focused on the perceptions of stigmatized individuals and on microlevel interactions, rather than attending to structural forms of stigma. This article describes the relatively new field of research on structural stigma, which is defined as societal-level conditions, cultural norms, and institutional policies that constrain the opportunities, resources, and well-being of the stigmatized. I review emerging evidence that structural stigma related to mental illness and sexual orientation (a) exerts direct and synergistic effects on stigma processes that have long been the focus of psychological inquiry (e.g., concealment, rejection sensitivity), (b) serves as a contextual moderator of the efficacy of psychological interventions, and (c) contributes to numerous adverse health outcomes for members of stigmatized groups-ranging from dysregulated physiological stress responses to premature mortality-indicating that structural stigma represents an underrecognized mechanism producing health inequalities. Each of these pieces of evidence suggests that structural stigma is relevant to psychology and therefore deserves the attention of psychological scientists interested in understanding and ultimately reducing the negative effects of stigma. (PsycINFO Database Record
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Emerging research has highlighted that structural forces not only impede implementation in their own right but also perpetuate and reinforce other barriers such as stigma and deprioritization of mental health care.
“This need for task-sharing interventions to be more responsive to and resistant against macro-level factors is echoed by emerging research that has highlighted the role that structural forces play in not only impeding implementation in their own right but also perpetuating and reinforcing other barriers (e.g., stigma, deprioritization of mental health care) [97–99].”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [99]
The sections on psychological interventions and stigma processes report that structural stigma can weaken intervention efficacy and is associated with individual-level stigma. They do not establish that structural forces impede task-sharing implementation or cause mental health care to be deprioritized. Page numbers were not available in our copy. (LLM, conf=0.86)
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- Authors
- Hatzenbuehler, M. L.
- Affiliations
- Columbia University (US)
- Corresponding author
- Hatzenbuehler, Mark L.
- Venue
- American Psychologist
- Published
- 2016-11
- Volume
- 71
- Issue
- 8
- Pages
- 742-751
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- PMC
- PMC5172391
- OpenAlex
- W2561252048
- Cited by
- 839
- References
- 39
- Citations by year
- 2026: 116 · 2025: 168 · 2024: 105 · 2023: 99 · 2022: 124 · 2021: 105 · 2020: 55 · 2019: 33 · 2018: 21 · 2017: 9 · 2016: 1 · 2015: 1
- FWCI
- 33.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- American Psychologist (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (K01DA032558)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- structural stigma, mental health stigma, sexual orientation stigma, concealment, rejection sensitivity, psychological intervention, health disparities, physiological stress response, premature mortality, institutional policy, cultural norms
- MeSH terms
- Mental Disorders, Female, Humans, Male, Psychology, Sexual Behavior, Stereotyping, Stress, Psychological, Social Stigma
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