Theoretical conceptualizations of stigma distinguish three dimensions of stigma: public, perceived, and self-stigma, which encompass unconscious biases, stereotyping, negative attitudes, prejudice. and discrimination. These attitudes and behaviors may have negative effects for people who have suicidal thoughts, suicide attempts, or suicide bereavement, eliciting feelings of shame and embarrassment and reducing future disclosure and help-seeking behavior. Although suicide stigma is often conflated with mental illness stigma, a growing body of literature suggests suicide stigma manifests in unique ways. Assessment of suicide stigma has matured in the past decade, with several scales developed to measure the stigma of suicide attempt. Using these established measures, a body of research is continuing to identify the factors associated with suicide stigma and the impacts of suicide stigma, particularly on suicidality, depression, and help-seeking. Future research directions for this nascent research field include understanding the processes by which stigmatizing attitudes emerge, better establishing the roles of personal stigma and self-stigma on mental health outcomes, and testing stigma reduction programs in the general community. Meaningful engagement with people with lived experience of suicide and understanding cultural differences may lead to more effective and impactful approaches for reducing stigma and preventing suicide.

Stigma can maintain discrimination and oppression and reduce compassion and understanding. In the area of mental illness and psychological help seeking, stigma acts as a considerable barrier to recovery and adds additional burdens to be managed. This reality has led many different research groups to explore the workings of stigma and ways to intervene to help people who suffer from the stigma associated with mental health problems. We wanted to create a state-of-the-science source for the best research being done in this area and so we organized the Handbook of Stigma and Mental Health. This chapter provides an overview to the Handbook and the excellent research that is reviewed in it. In their chapters, the authors of the Handbook answer four important questions: “What are the forms of mental health stigma?”; “What are impacts of mental health stigma?”; “How can we develop interventions to reduce mental health stigma across contexts?”; “How can we understand the specific ways that mental health stigma impacts different groups (e.g., racial minorities, veterans)?” We hope that asking these questions will stimulate and drive more innovative research in the future.

Stigma is a powerful force that is not easily dismantled. The goal of the Handbook of Stigma and Mental Health is to assist with policy changes, interventions, and movement toward social justice by presenting the breadth and depth of the work on mental health stigma. The authors of the Handbook have provided a deep and more complete picture of what stigma is, how it might develop, and how it might be changed. The authors also have provided a clear picture that stigma cannot be understood in isolation, but rather intersectional and contextual approaches are best. Through the work reviewed by the authors of the Handbook, it is clear that research is still needed to expand on what situations and under what conditions stigmas could be minimized, reduced, buffered, or eliminated. Also, work needs to be done to create culturally affirming approaches to stigma reduction. We believe the work presented in the Handbook provides optimism about the changes that have been made and the progress in our knowledge and interventions. It also provides insights into developing unique perspectives on the field, challenging some of our well-worn ideas, and pushing the limits of our knowledge.

This chapter provides an overview and delineation of the four major stigmas related to mental illness and seeking psychological help: public stigma of mental illness, public stigma of seeking help, self-stigma of mental illness, and self-stigma of seeking help. It begins with discussion of a theoretical model that distinguishes these four stigmas, outlines how they relate to each other, and asserts how they relate to mental health and help-seeking outcomes. We then discuss the evidence for the assertions of the model and the theoretical distinction of these forms of stigma. The chapter concludes with discussion of a possible new type of stigma, future directions, and cultural considerations.

Self-affirmation theory provides a sophisticated framework to understand individual differences in receptivity to health-risk communication. Health messages are often ineffective because reminders of health risks can create dissonanc, which causes people to react negatively against the perceived threat of the information. Self-affirmation interventions offer a brief and practical means of improving health communication and promoting positive change. The primary purpose of this chapter is to highlight the promise of self-affirmation in understanding and reducing mental health stigma. The chapter aims to provide a theoretical background and practical path forward for researchers and clinicians, public health professionals, mental health activists, and any persons interested in dismantling the negative stereotypes and judgments associated with mental health and seeking professional psychological help. Specifically, the chapter aims to (1) briefly summarize the relationship between mental health stigma and psychotherapy use, (2) describe self-affirmation theory and its applied intervention effects in reducing perceptions of psychological threat across levels of measurement, (3) describe a standardized method of inducing self-affirmation by reflecting on personal values, (4) examine self-affirmation’s extension to mental health stigma and professional help seeking, (5) explore potential underlying mechanisms of change, and (6) suggest future directions for research and practical application.