Future Directions in Mental Health Treatment with Stigmatized Youth

Abstract

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, 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.

Treatment Personalization Can Promote Mental Health Equity by Addressing Stigma

“…In order to reduce clinician bias, widespread efforts to train clinicians in culturally-responsive practices are necessary. Training intervention development should maximize generalizability for clinicians (e.g., be relevant to those adhering to a wide variety of theoretical approaches) and clients (e.g., be relevant to multiple stigmatized groups), informed by key community members (e.g., clients, expert clinicians), leverage cutting-edge behavioral science (e.g., utilize empirically supported techniques associated with behavior change and bias reduction) and optimize scalability (e.g., online trainings; see Price & Hollinsaid, 2022 for additional recommendations). To reduce mental health inequities at scale, it will be important for large accrediting bodies (e.g., the American Psychological Association, National Association of Social Work) and training programs to require more substantive and effective training in culturally-responsive care.…”