Knowledge base Updated 2 November 2026 1 views

Stigma

The process by which a characteristic is labelled, linked to negative stereotypes, and used to separate and devalue people — producing discrimination, and operating at structural, public and internalised levels.

Definition

Link and Phelan define stigma as the co-occurrence of five components in a situation where power is exercised: labelling a human difference, stereotyping the label, separating us from them, status loss and discrimination, and the power to make all of that stick.

The power clause is what distinguishes stigma from prejudice in general and is the part most often omitted.

Three levels:

Structural: laws, institutional practices and resource allocation.
Public: attitudes and behaviour of others.
Self or internalised: applying the stereotype to oneself, with consequent shame and withdrawal.

Courtesy stigma extends to families and to those who work with the stigmatised group.

History

Goffman's 1963 essay is the founding text and framed stigma as a spoiled identity produced in interaction.

Link and Phelan's 2001 reformulation moved the concept from an attribute of a person to a social process involving power, which is the version most current research uses.

Theory

Two findings have shaped the field's strategy, both by contradicting what was expected.

Biogenetic explanations do not reduce stigma. Campaigns framing mental illness as an illness like any other were expected to reduce blame, and they do reduce blame — while increasing perceived dangerousness, perceived permanence and desire for social distance. This is one of the most consistent findings in the literature and it invalidated a decade of anti-stigma campaigning.

Contact works better than education. Interpersonal contact with a member of the stigmatised group produces larger and more durable attitude and behaviour change than information does, in both meta-analyses and trials.

Modified labelling theory explains the mechanism for self-stigma: people learn cultural stereotypes long before they are labelled, and on being labelled apply those stereotypes to themselves, which predicts withdrawal, secrecy and reduced help-seeking.

Research

Stigma predicts delayed help-seeking, treatment discontinuation, reduced employment and housing access, and poorer physical healthcare — the last through diagnostic overshadowing, in which physical symptoms are attributed to a psychiatric diagnosis and not investigated.

The mortality gap for people with severe mental illness, commonly estimated at 15 to 20 years, is driven mainly by physical illness that is under-treated, which makes structural stigma a mortality issue and not only an experiential one.

Anti-stigma programme evaluation is mostly short-term and attitude-based. Evidence that campaigns change behaviour or structural outcomes is much thinner than the volume of campaigning implies.

Applications

Anti-stigma programme design, which the evidence points toward contact-based, targeted at specific groups such as employers or clinicians, and sustained rather than campaign-shaped.

Also: mental health legislation, disclosure decisions and the support of them, service design that does not require humiliating gatekeeping, and language guidance in publishing and journalism.

A psychology platform sits directly inside this: how conditions are described on a public page is part of the public-level process.

Criticism

Illness-like-any-other messaging backfired, and it is still used.
Most evaluation is attitudinal and short-term, which is the easiest thing to measure and the least important.
Structural stigma is under-researched relative to individual attitudes, partly because it is harder to study and partly because it implicates institutions that fund research.
Measurement varies enormously, so meta-analysis in this area aggregates instruments that do not measure the same thing.
The concept is broad, and stretching it across every devalued characteristic reduces its analytic precision.

References

Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall.
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363-385.
Corrigan, P. W., Morris, S. B., et al. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963-973.
Kvaale, E. P., Haslam, N., & Gottdiener, W. H. (2013). The 'side effects' of medicalization. Clinical Psychology Review, 33(6), 782-794.
Thornicroft, G., et al. (2016). Evidence for effective interventions to reduce mental-health-related stigma. The Lancet, 387(10023), 1123-1132.

Written for PsychologyOrbit and reviewed before publishing. It is a summary for professionals and students, not clinical guidance, and it is not a substitute for the primary sources listed above.