Stigma is a prejudice (negative attitude) based on stereotypes usually leading to discrimination. Familiar mental illness stereotypes (weak, violent, comic) drive prejudice in society. Discrimination ranges from simple avoidance through exit life events (relationship, employment and housing losses) and institutional discrimination (denial of health interventions, insurance, jury service, visa inter alia). Stigma-discrimination cannot occur without a power differential. When a person with mental health problems shares societal prejudices, their self-stigma contributes to further morbidity and status loss. Reducing stigma requires multiple interventions: a language of inclusion (no more ‘schizophrenics’), legal and organisational reforms, and cultural changes based on empowerment.