Mental health is often stigmatized because of a lack of understanding about what mental health conditions are and what it’s like to live with a mental health condition. Stigma can also arise from personal thoughts or religious beliefs about people who have mental health conditions.

Generally, the lack of understanding about mental health — as well as the harmful assumptions about people living with mental health conditions — is at the heart of a bias or stigma. This can result in avoidance, rejection, infantilization, and other discriminations against people who are neurodivergent or have a mental health condition.

We often use the word “stigma” to describe the overarching experience that people have. However, there are actually three types of stigma: public stigma, self-stigma, and institutional stigma.

• Public stigma: This refers to the negative attitudes around mental health from people in society.
• Self-stigma: This describes the internalized stigma that people with mental health conditions feel about themselves.
• Institutional stigma: This is a type of systemic stigma that arises from corporations, governments, and other institutions.

While there are many examples of mental health stigma in society, here are some of the more common instances you might notice:

• When people are viewed as attention-seeking or weak when they try to reach out and get professional help.
• When others use harmful language, such as “crazy” or “insane”, to judge or trivialize people who have mental health conditions.
• When people make jokes about mental health or certain conditions.
• When people avoid others with certain mental health conditions, like schizophrenia, because of fear or misunderstanding.
• When family or friends tell someone with depression that they can get better if they just “work out and get more sun,” or make other unhelpful judgments.
• When someone living with a mental health condition views themselves as worthless or talks down to themselves because of their condition.
• When companies refuse to hire someone or provide them with adequate accommodations because of their mental health.
• When people view examples of neurodivergence as illnesses or something to be cured.

A 2021 study explored the trends of mental health stigma in the United States over a period of more than 20 years, between 1996 and 2018. In the study, researchers reviewed surveys from across the country on attitudes toward various mental health conditions, including schizophrenia, depression, and alcohol dependence.

According to the study results, from roughly 1996 to 2006, people became more knowledgeable about mental health — including acknowledging differences between daily experiences and symptoms of diagnosable conditions.

And from around 2006 to 2018, there was a significant decrease in social stigma against depression — specifically, less desire to be socially distanced from people with depression. However, when it came to schizophrenia and alcohol dependence, not only did social stigma increase but so did negative perceptions of these conditions.

Another earlier study from 2018 took a slightly different approach in analyzing the social perception of mental and physical health conditions. In this study, researchers used automated software to track over a million tweets related to mental health and physical health over a 50-day period.

According to the results of the study, mental health conditions were more likely to be stigmatized and trivialized than physical health conditions. And the results varied by condition — with schizophrenia being the most stigmatized, and obsessive-compulsive disorder (OCD) being the most trivialized.

Intersectionality refers to how someone’s intersecting identities — such as race, gender, sexuality, or class — contribute to their own unique experience with discrimination and oppression.

When it comes to mental health, intersectionality can play a huge role not only in someone’s overall mental health, but also in how mental health stigma affects them.

For example, research suggests that Black and Latino people experience mental health conditions more severely and persistently than other racial or ethnic groups. Much of this imbalance stems from factors like institutionalized racism, prejudice, and other outside circumstances.

Another study from 2021 looked into the use of mental health services by young Black gay, bisexual, and other men who have sex with men in HIV care.

According to the researchers, less than 20% of the men who were referred to mental healthcare from the clinic continued to receive the recommended care — often as a result of increased social and professional stigma for men to go without mental healthcare of any kind.

Mental health stigma can have a hugely negative impact on the lives of people living with mental health conditions. In fact, stigma can often lead to mental, social, or even professional consequences for the people who are stigmatized.

Mental

People living with mental health conditions are more likely to experience low self-esteem and lower self-confidence if they’re stigmatized.

Stigma may lead to difficulty seeking treatment or even following through with treatment. And some people may experience increased symptoms of their condition, or even develop new ones — like anxiety or depression — because of experiencing stigma.

Self-stigma may even hinder someone’s ability to recover from a mental health condition. In one smaller study from 2018, researchers found that higher levels of self-stigma were associated with a decrease in recovery from mental health conditions.

Social

Social mental health stigma may lead to isolation from friends or family. People with mental health conditions may experience bullying or harassment from others — or possibly even physical violence.

And when others have a judgmental view of mental health, it can be difficult for people living with these conditions to build relationships with them.

Research has shown that perceived and experienced social stigma may also play a role in suicidality among people with mental health conditions. According to the literature, people who experience discrimination (even anticipated discrimination), social stigma, and self-stigma may be more likely to experience suicidal ideation.

Professional

Stigma in the professional world can lead to fewer opportunities to excel at school and fewer opportunities to advance at work. People living with mental health conditions may have difficulty fulfilling school or work obligations — especially if they have trouble with classmates, teachers, coworkers, or bosses.

It’s not just classmates or colleagues who contribute to mental health stigma in a professional setting, either. Research suggests that when healthcare professionals exhibit negativity toward people with mental health conditions, or have a lack of understanding about these conditions, it can prevent people from accessing high quality care.

Stigma comes from everywhere — institutions, society, and even ourselves. But we can all take steps to address and reduce the stigma of mental health:

• Learn about mental health: One of the most important steps toward reducing mental health stigma is to learn more about it. Learning what mental health conditions look like and who they can affect can help reduce some of the fear, misunderstanding, and judgment around them.
• Use words carefully: When we use words with negative associations, like “insane” or “crazy”, we contribute to the judgment and stigmatization of others. It may take some effort to change the way we speak, but it can help reduce the stigma that people with mental health conditions face.
• Take part in campaigns: Many mental health organizations, like NAMI, create fundraising campaigns to help bring awareness and provide funding for mental healthcare. Even if you can’t get directly involved, these campaigns are a great way to learn more about people living with mental health conditions.
• Share your story: If you’re someone living with a mental health condition, one of the most powerful tools for reducing stigma is to share your story. By educating people on what it’s like to live with a mental health condition, we can help reduce the misunderstanding and judgment that people feel.

Mental health stigma plays a significant role in the lives of people with mental health conditions — from the way that they’re treated to the way they feel about themselves. But we can take steps to reduce this stigma.

By being more mindful about how we speak to others, learning more about what it’s like to live with a mental health condition, and sharing our stories when we’re living with these conditions, we can help reduce the stigma surrounding mental health.

Yes, you can get medical care if you don’t have health insurance.

In the United States, hospital emergency rooms are required to provide treatment regardless of insurance or ability to pay.

Additionally, there are many medical facilities that provide routine care to people who don’t have insurance. You will be asked to pay for any care you receive, but there are ways to find healthcare at a lower cost.

There are a variety of options for seeking care if you don’t have insurance. Many of these options are designed to be affordable. In some cases, you might be able to get certain healthcare services for free.

You can find low cost or free care in several locations:

Community health centers

Community health centers are nonprofit health clinics that offer low cost or free care. Often, fees are set on an income-based sliding scale, and staff will work with you to determine your costs.

The exact services offered by a community health center depend on the location but generally include:

• preventive healthcare
• basic healthcare
• family planning services
• vaccinations
• chronic condition management

Some community health centers also offer prescription medications and dental care. You can search for community health centers near you by checking here.

State or county departments of health

Your state or county department of health might cover certain healthcare services for eligible residents. Often, this includes access to preventive care, such as vaccines or screenings.

You might need to register in advance and prove that you reside in the county or state to receive free care.

You can search for your local department of health here.

Urgent care and walk-in clinics

Urgent care centers and walk-in clinics offer care without an appointment. Often, these facilities offer reduced cost care for people who don’t have insurance. Some urgent care centers list costs for standard services on their websites.

You can also call ahead to talk with a representative about fees and possible cost reductions for people without insurance.

Pharmacy care clinics

Pharmacies, including the pharmacies inside major national chains such as Walmart, often provide preventive care services for free. These services are normally provided during health clinics held on specific days.

Services offered can vary but typically include:

You can check with your local pharmacy about any upcoming clinics, or search online for pharmacy clinics in your area.

Teaching hospitals

If you have a teaching hospital in your area, you might be able to receive care at a reduced rate. The exact care you can access at a reduced rate depends on the hospital and the needs of the medical students.

You can call the teaching hospital and ask whether they offer any reduced cost care.

Employer-sponsored wellness programs

Some employers offer wellness programs to their employees. In many cases, this includes preventive healthcare, such as annual vaccines and healthcare screenings.

You can check in with your human resources department if you’re not sure what healthcare benefits are part of your employer’s wellness program.

The National Association of Free & Charitable Clinics

You can use the National Association of Free & Charitable Clinics website to search for health clinics and pharmacies in your area that offer free or low cost services.

The association is dedicated to caring for people who are uninsured or underinsured. There are more than 1,400 clinics and pharmacies in the association.

If you need assistance paying for care, you have a handful of options:

Charity care

Some states offer charity care that reduces the cost of medical care for people who meet income requirements. If you qualify, you can receive low cost or free medical care.

In certain states, people are screened automatically. In other states, you will need to apply for the program.

Medicaid

Medicaid is a federal program that provides healthcare for people who meet income requirements. Each state oversees its own Medicaid program. Income limits and exact coverage vary by state.

You can find your state’s Medicaid website here.

Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is a federal program that provides healthcare for children. Just like Medicaid, qualifying for the program depends on income level. Each state sets its own income limits and coverage varies.

You can read about CHIP in your state here.

The Hill-Burton program

The Hill-Burton program provides funds to participating hospitals and healthcare facilities in exchange for offering a set amount of free or low cost care to people who meet income requirements.

You will need to apply for the Hill-Burton program with the admissions or business department of the healthcare facility. You can find a directory of Hill-Burton facilities here.

Aunt Bertha

Aunt Bertha is a social and human services database you can search to find programs in your area. This includes programs that can help you pay for healthcare.

You can enter your ZIP code and a category to find programs that will meet your needs.

Keeping prescription costs low is a great way to lower your overall healthcare costs. Here are some options:

Prescription drug manufacturer programs

The makers of many prescription drugs offer programs to help people afford their medications. You can often join these programs to get your medication at low or no cost. You might need to meet certain income requirements to qualify.

You can use RXAssist to search a database of manufacturer programs.

GoodRx

GoodRx is a website that will show you the prices of your medication at stores in your local area. It can also show prices at online and mail-order pharmacies. By comparing pharmacies, you can find the lowest price.

Plus, GoodRx will even help you find coupons and manufacturer discounts.

Pharmacy memberships

Walmart, CVS, and other pharmacies have membership programs that can save you money. By signing up for these programs, you can get access to discounts on your medication. You can also earn discounts to use on other pharmacy purchases.

Grants for charitable organizations can cover your medical costs. Some examples include:

The PAN Foundation

The PAN Foundation helps uninsured people who have received a diagnosis of a life threatening, chronic, or rare disease pay for their medical care. You can see a list of conditions the foundation currently provides assistance for on its website.

If you have a condition listed on the site, you can instantly check your eligibility and can then apply online for a grant.

The HealthWell Foundation

The HealthWell Foundation helps uninsured people with certain medical conditions pay for their medical expenses. You can see their list of covered conditions on its website.

If you have a condition covered on the site, you can apply for a grant that will cover your medical expenses.

Good Days

Good Days is an organization that can help people with chronic and acute conditions pay for their medical treatments. You can check out the list of covered conditions here.

Applications for assistance are available in both English and Spanish.

There are a few additional options you can explore to get access to lower cost or free healthcare. If you haven’t already, consider doing the following:

• Ask the hospital or doctor’s office about installment payment programs.
• Search for programs specific to a health condition you have.
• Apply for low cost health insurance on the Health Insurance Marketplace.
• If you’re a veteran, apply for VA benefits.
• Sign up for clinical trials in your area to help researchers study new treatments.
• Consider telehealth for conditions that don’t need in-person care.

You can learn more about accessing medical care without insurance by reading answers to common questions.

When can I enroll in Medicaid?

If you qualify for Medicaid, you can enroll at any time. Check out your state’s Medicaid website for income limits and other details.

What if I can’t pay an emergency room bill?

In an emergency, getting care is your No. 1 priority. But this can leave you with a bill that is outside of your budget, especially if you don’t have insurance.

However, medical bills are often negotiable. In many cases, you can call the hospital’s billing department to work out a plan.

If you’re unable to work out a plan with the hospital, there are nonprofit organizations that can help you apply for debt forgiveness.

Will healthcare professionals treat me if I don’t have insurance?

It’s illegal for healthcare professionals to refuse care in an emergency.

This isn’t the case for nonemergency care. Most healthcare professionals will list payments they accept on their websites.

If private pay is listed, you can get treatment without insurance. If it’s not, it’s best to call in advance to make sure the healthcare professional accepts patients who don’t have insurance.

You have options for receiving medical care even when you don’t have health insurance. There are several sources you can turn to for care, prescriptions, payment help, and more. Some programs are limited to certain states or certain health conditions.

Additionally, you will need to meet income requirements to qualify for some of these programs. If you don’t, options like telehealth and urgent care can help you cut costs.

You can also look into getting affordable insurance through the Health Insurance Marketplace.

This training was created for wellness workers, everyday community members and individuals working, living in, and supporting Black and marginalized communities.

This tailored focus to build capacity with community members began in 2018 and flourishing through 2021.

The training’s curriculum focused on applying and providing emotional support through a healing justice framework.

Other goals for participants included:

• To challenge and provide accurate information on common myths on medication, psychology, and mental health in Black communities.
• To name and identify common mental health diagnoses, challenges, and mental health treatments in Black communities.
• To identify and map out strategies and resources in their own communities.

One important way these goals were accomplished was through ongoing conversations surrounding race, gender, class, and sexuality, allowing for skill-building practice in tangible and concrete ways.

Rates of depression for people within helping professions — occupations that provide supportive health and education services to others — are staggering.

As much as 90 percent of healthcare professionals reported active depressive symptoms, and over half of mental health professionals report experiencing caregiver burnout.

According to data from the National Alliance on Mental Health (NAMI), medical mistrust and systemic racism play a heavy role in healthcare treatment.

For example, a recent study showed that in addition socioeconomic factors such as income and city location, people from Black and Latin communities reported having less trust in the medical system than their white counterparts.

Despite the ongoing effects of compassion fatigue and cultural competency being a major factor when it comes to engaging the Black community in our emotional well-being, Robinson and the training participants shared how most mental health focused trainings fail to address identity within their curriculum.

Understanding the gravity of identity’s connection to the mind and body when it comes to healing, Robinson ensured a holistic viewpoint was taken in the development of the BMHHJ curriculum by using a healing justice framework.

Created by Cara Page and the work of the Kindred Southern Healing Justice Collective, this framework is built on a holistic response to generational trauma and violence that alters the impact of oppression.

“Healing justice is unique in that it holds that we have to discuss the history of eugenics and racism in psychology,” Robinson says in the report.

“We can’t pretend these systems were always, or are currently, safe for our folks. We have to give folks tools to navigate with caution and advocate vigilantly so that we can not only survive, but thrive.”

People of color have continually experienced harm within the medical and mental health systems throughout history.

We still have to navigate these systems, both as practitioners and patients, and this program is unique in addressing the reality of those experiences while providing practical tips and strategies to do so.

“It validates the legacy of the abuse within the system and the feelings of distrust as legitimate, all while understanding that ongoing skepticism is not only warranted, but needed as Black people who are navigating the system,” Robinson said.

Participants have shared how it was incredibly affirming to have the harm they’ve experienced within the medical and mental health systems to be not only acknowledged, but validated.

Seeing People as Whole Beings

The facilitators of the training used an embodied approach to teaching. The program aims to honor people’s various needs, and for BMHHJ, this looked like the intentional acknowledgement of a connection between the mind and body.

“We get people into role plays, we create opportunities for dance breaks, and [other] activities to help them really acknowledge the ways in which distress can sit in their body,” Robinson shared.

Participants had access to coloring sheets and crayons for doodling, which can be helpful for processing according to studies like this one from 2009. An aromatherapy table, altars, and healing crystals were all available for use during the sessions.

In addition to these tools and practices throughout the sessions, facilitators also held guided meditations and engaged in a closing circle at the end of the sessions.

Honoring participants’ needs also included space for breathwork and acknowledging the heaviness of the training content instead of diving into heavy topics without pauses.

“We’re not going to show you six slides of deeply distressing information and then act as if this is divorced from everything else happening,” Robinson told us.

Healing for Healers

“People have come to this program and come away with not only feeling like they’ve learned a lot, but feeling like they’ve gotten healing as well,” Yolo said.

“Our approach to this curriculum was for everybody in this ‘village’ to see themselves as a creator of wellness,” Robinson said.

He spoke of pushing against the idea of only certain people with particular affiliations or professional standing as having an ability to create wellness and healing.

Instead, Robinson encourages everyone to see that they can have a role and agency within healing and wellness, regardless of what the role may look like.

There are tangible results from this report that should be seen as a viable and worthwhile mental health intervention. This is true not only for folks that the participants will work with, but for the healing practitioners themselves.

Initially, the training was held in Los Angeles and led by Robinson and Woodland.

After initial success, it then expanded to other parts of the country and enlisted the help of mental health professionals Dionne Bates, PhD, LPC, CPCS, Micheal Chan-Frazier, PhD, LPC, and L’Oréal McCollum, LMSW, M.Ed.

These folks offered their curriculum development and facilitation expertise, and with the help of partnering organizations like The Kresge Foundation, BEAM was later able to create tailored versions of the curriculum, further expanding the reach of the training.

Impact of COVID-19

The training team navigated through the beginnings of the COVID-19 pandemic by shifting their two day in-person training to a virtual program held via Zoom.

While this change took increased time and effort, the report showed a positive outcome.

In addition to participants continuing to engage in the intimate curriculum, shifting to a virtual setting allowed participants from varied places in the US to join in.

For BIPOC folks navigating Western-centric systems of health and wellness, the fullness of who we are isn’t always acknowledged, let alone welcomed. This newly-released report shows that tending to the connection between mind and body is imperative.

The curriculum and facilitator focus on addressing the role and history of race, gender, sexuality, and class within health systems has proven to be essential with lasting and widespread effects.

The role of someone working in peer support or a helping profession isn’t a light one; the combination of daily systemic biases and the added layer of expected resilience can have damaging effects on both the wellness practitioner and their clients.

For the past three years, the BMHHJ training has tackled these topics, not only uplifting and modeling the ways that practitioners can support their communities in the aftermath of oppressive systems, but how they can recognize their own power and better support themselves.

“People have left this training empowered knowing that mental wellness is not synonymous with mental illness,” said Bates.

“[They left] empowered knowing that they and their communities have a right to healing; empowered with skills that they can take back to their communities to cultivate a legacy of healing and equity.”