Recent research from across the world has found that stigma towards people with mental health diagnoses is either increasing or stagnant. While studies from the US have found that stigma towards people with a depression diagnosis has decreased, stigma towards other diagnoses such as schizophrenia and substance use has increased.
One US-based study found that although a majority of participants said they were comfortable talking about mental health, many also reported withholding information about their own mental health from friends and doctors. Another study out of the US found that “concerns about stigma” was a top three reason that participants did not seek help for mental health issues. Educational campaigns have largely failed to reduce mental health stigma, with some data indicating that mental health literacy interventions may make the problem worse.
The authors of a new study published in the American Psychologist argue that system justifying beliefs, and economic system justification in particular, may be a factor in the stubborn pervasiveness of mental health stigma. The current work, led by Jussi Valtonen of New York University, finds that belief in the legitimacy and fairness of the current US economic system was the strongest predictor of stigmatizing attitudes towards people with mental health difficulties. This research additionally finds that participants reported less stigmatizing attitudes when the person displaying mental health symptoms was described as having high financial status.
“We found that the more people reported believing that the (current American) economic system works in a fair and just way, the more likely they were to have negative reactions toward individuals with mental health problems,” said Valtonen in an interview by email. “If you start mentally from the assumption that the economic system works in a fair and just way – i.e., people typically get what they deserve and deserve what they get – it’s much harder to consider how that same system could be to blame for anyone’s difficulties. So it may become easier to assume that the person has done something to cause the difficulties they’re in.”
The Effects of System Justification
Experts have argued that system justification serves several functions for people that adopt these beliefs. It can reduce uncertainty, social discord, and the perception of threat. It may also serve the “palliative function of increasing satisfaction with the status quo.” For example, research has found that system justifying beliefs were linked to lower levels of psychological distress and higher levels of subjective well-being and self-esteem in disadvantaged minority groups, as well as fewer mental health problems in girls. However, another study found that the increased well-being associated with system justification reverses over time, eventually leading to worse mental health outcomes.
These beliefs are likely most harmful for people from oppressed and disadvantaged groups. Research has linked system justifying beliefs to increased psychological distress in minority mothers, behavioral issues in minority children, as well as internalization of inferiority and reduced motivation for collective action in disadvantaged groups.
The current research, comprised of three separate studies, also associates these beliefs with mental health stigma, which previous studies have linked to discrimination in employment, housing, and social inclusion, reduced-help seeking behavior, and reduced quality of life.
Study One
The goal of the first study was to examine the role of system justification in stigmatizing beliefs towards people with mental “illness.” The authors recruited participants using Amazon’s crowdsourcing tool Mechanical Turk. Participants replied to an online, self-report survey around general system justification, economic system justification, negative stereotypes towards mental “illness,” desire for social distance from people with mental health problems, personal experience of mental health services, political orientation, and beliefs about genetic determinism. In total, the authors examined data from 368 participants. The majority of the participants were female (57.3%), white (78.8%), and college educated.
System justifying beliefs, economic system justification, and political conservatism were all associated with negative attitudes and perceptions of people with mental health issues, with economic system justification showing the strongest link. Further analysis found that economic system justification accounted for nearly all observed associations between general system justification, political conservatism, and stigma towards people with mental health struggles. This means that economic system justifying beliefs were the best, most consistent predictor of stigmatizing attitudes.
Personal experience with mental health services was linked to more tolerant attitudes and less stigma towards people that struggled with mental health. The authors note that surprisingly, belief in genetic determinism showed either weak or no links with negative attitudes towards people with mental health issues.
The observational nature of the study means this data cannot definitely say that economic system justification causes mental health stigma, only that they are related. The self-report nature of the survey makes the data susceptible to bias by misreporting or reporting what the participant believes is most socially acceptable rather than their true beliefs. The authors used a convenience sample, limiting generalizability to other populations within the US. The sample was composed entirely of US participants, limiting generalizability to other populations.
Study Two
The goal of this study was to see if the findings from study one could be replicated with a representative sample of people from the US. The authors used the research firm Cint to recruit a representative sample of participants. As in the first study, these participants answered online self-report surveys around general and economic system justification, political orientation, and stigmatizing attitudes towards people with mental health struggles. Genetic determinism was omitted as it showed little to no association with stigma in the first study. In total, the researchers examined data from 1,028 participants.
Economic system justification was the factor most strongly linked to social intolerance, personal blame, negative stereotypes, recovery pessimism, and exclusionary sentiments towards people with mental health issues. As in study one, economic system justification was the variable most strongly and consistently linked to mental health stigma.
This study, like study one, could not speak to causes of mental health stigma, only linked factors. This study also had the same limitations in terms of self-report surveys and limited generalizability to populations outside the US.
Study Three
The goal of this study was to examine how a person’s position within the economic system may effect mental health stigma towards them. The authors recruited participants through the crowdsourcing platform Prolific and presented them with four vignettes to each participant describing a person with:
- Symptoms of depression and high financial status
- Symptoms of depression and low financial status
- Symptoms of social phobia and high financial status
- Symptoms of social phobia and low financial status
The subjects in the vignettes were not labeled as having a depression or social phobia diagnosis, but were described as presenting behaviors consistent with these diagnoses. The authors conveyed low financial status by describing the subject as earning little money and having financial problems. High financial status was conveyed with a description of the subject as earning very good money and having no financial problems.
After being presented with the vignettes, the participants answered questions concerning levels of social tolerance for the subjects from the vignettes. The participants also answered questions about their personal experiences with mental health issues and demographic characteristics. In total, the authors examined data from 118 participants.
Participants were more willing to live next door, socialize, and make friends with the subjects from the vignettes than to work closely with them or have them be married into their family. Participants showed the most resistance to having people with symptoms of depression and social phobia married into their families compared to the other forms of social acceptance. Participants also reported more social tolerance towards people with social phobia than depression.
Financial status was linked to all forms of social tolerance for both depression and social phobia, with participants reporting more tolerance for people with higher financial standing. While participants with experience of mental health issues generally showed more tolerance, they showed a similar pattern of being more socially accepting of wealthy subjects.
This study has similar limitations to the first two in terms of self-reporting data. This study also has limited generalizability due to the small sample size and the sample not being random or representative. Generalizability outside the US context is also limited.
The authors write:
“These results extend the findings from Studies 1-2, demonstrating that there is a causal association between economic factors and mental health stigmatization. For conditions such as depression and social phobia, an individual’s position in the economic system shaped how others responded to them, regardless of whether perceivers had experienced mental illness themselves. While participants with personal experiences of mental illness were more tolerant in general, even these participants were more likely to distance themselves from poorer (vs. wealthier) individuals suffering from mental illness. ”
System Justification Theory and Mental Health Stigma
System justification theory (SJT) is a framework developed by social psychologists to explain why people tend to defend and justify the social, economic, and political systems under which they live, even when they are disadvantaged and harmed by those systems.
“From an SJT perspective, if people are motivated to see the economic system as fair and legitimate, they are more likely to interpret suffering in ways that protect that belief,” said SJT expert Evan Valdes in an email interview. “That often means emphasizing individual responsibility rather than structural constraints. In that context, psychological distress can be framed as a personal failing rather than a predictable response to adversity. My interpretation is that when fairness and meritocracy are strongly endorsed, long-term distress can be seen as norm-violating, which increases blame and social distance.”
Tara Thiagarajan, neuroscientist and expert on how environments can impact brains and minds, argues that while system justification beliefs assume that everyone has a fair chance to succeed and flourish, in reality, our environments shape us in substantial ways.
“When people think our economic system is fair and legitimate they assume that these systems are giving everyone a fair chance of determining their own life and the environment they live in. Thus any problems are assumed to arise because of your own intrinsic make-up,” Thiagarajan said in an interview by email. “The current system assumes that the individual bears the responsibility for the mental health outcome. This causes people to ‘blame’ them for having the problems they do which is what creates the stigma. However evidence is mounting that the factors that drive these outcomes are largely environmental and out of our control – from a highly processed food system full of neurotoxic additives and more neurotoxins in the air and water to addictive smartphone algorithms and poor social structures.”
Valtonen points to the currently dominant biomedical model of mental “illness” as being largely implicated in mental health stigma. This model, the current status quo that would be protected by system justifying beliefs, places the cause of mental health struggles within individuals rather than within the often pathological environments where they live.
“Rather than helping us to see how we’re all profoundly affected by social and economic arrangements, the biomedical model guides us to ignore their role in mental health by suggesting that psychological distress is best understood as a problem solely in an individual’s mind/brain,” explains Valtonen. “In addition, the biomedical model may make things worse in terms of stigma by accentuating the difference between those seen as ‘healthy’ or ‘normal’ versus those who are seen as ‘ill’.”
Research corroborates this understanding of the shortcomings inherent in the biomedical model of mental “illness,” with multiple studies linking this model to increased mental health stigma.
Financial Status and Mental Health Stigma
The current work found that people had less stigmatizing attitudes when subjects displaying symptoms of depression and social phobia were described as having high financial status. SJT would point to “status cues” as one possible explanation for this finding.
“Status cues shape how identical behaviors are interpreted. Higher-status individuals are often perceived as more competent and trustworthy (a finding quite robust in the SJ literature), so their distress may be seen as temporary or situational,” explains Valdes. “Lower-status individuals are more likely to be judged as irresponsible, lazy, or deficient. This suggests that what looks like ‘mental illness stigma’ may partly reflect class-based stigma. Even people with lived experience can internalize these narratives, especially when they are culturally dominant.”
Thiagarajan has a similar take, pointing to faulty assumptions linking high financial status to competence as a possible reason participants were more socially accepting of high financial status individuals, even when they displayed the same symptoms as their low financial status counterparts.
“My guess would be the following: if you believe in the fairness of our economic institutions, then if you have high economic standing people assume you must be a smart person to get there and therefore any mental illness must be externally driven. In contrast when someone is poor then people assume they must be poor because they are not as mentally capable and therefore any mental illness must be their own fault.”
Reducing Stigma Beyond Educational Campaigns
Valdes believes anti-stigma campaigns often fail as a result of emphasizing the biomedical narrative around mental health. In order to combat stigma, he recommends systemic change, a focus on things that connect us, and an acknowledgment of the role of structural factors that contribute to mental health struggles.
“Purely informational campaigns often have mixed effects, particularly if they frame mental illness as chronic, biological, and immutable. Approaches that emphasize contact, shared vulnerability, and structural contributors to distress may be more promising. Reducing stigma may also require institutional changes — for example, minimizing coercion, increasing peer involvement, and reducing the scarcity logic that fuels deservingness judgments. Belief change alone is unlikely to be sufficient if institutional practices continue to signal that people in distress are risks or burdens.”
He also points to the centering of lived experience in both mental health research and clinical practice as important in combating stigma.
“In practical terms, it could mean co-producing research and services with people who have lived experience, embedding peer leadership in decision-making roles, and strengthening rights-based, voluntary care models. It also involves taking seriously how economic inequality, housing instability, and labor precarity shape mental health.”
Past research has found that an emphasis on systemic, social, and environmental causes of mental health struggles is linked to reduced stigma. Studies have also found improved clinical outcomes and reduced stigma as a result of centering lived experience in research.
Valtonen believes one problem with current efforts to reduce stigma is a narrow focus. He views stigma, and educational campaigns’ failures at reducing it, as a consequence of artificially separating mental health from larger questions about the human condition.
“I’m personally inclined to think that focusing on stigma itself is probably not a great idea. I don’t think the root of the problem is that we haven’t quite found the optimal stigma intervention yet, but that we’re asking the wrong questions. I think we’ve got a much broader question wrong as Western societies, namely that we’ve come to view mental health and forms of psychological distress through an overly narrow lens. It seems to me that a major obstacle in our efforts to respond both to stigma and to mental health problems is that we’ve come to disconnect mental health from larger questions about life and humanity, and this disconnect has created enormous societal blind spots, including the assumption that we can fix things like people’s reactions to each other by educational campaigns.”
For Valtonen, stigma reduction could be best achieved by focusing more broadly on the things that connect us as human beings.
“Instead of focusing on stigma, I think we would be wiser if we asked broader questions about what the things are that we all need as human beings to live meaningful and connected lives, and asked how we could all learn to treat each other with compassion and dignity. There are so many things that we all share and that connect us to each other, regardless of our individual struggles, and I believe that a deeper recognition of this could hopefully make it a little easier for us to understand each other.”
In addition to a broader approach, Valtonen emphasizes the importance of lived experience and mad studies in the future of mental health narratives.
“I see the emerging field of mad studies as a really important development in opening up new ways of thinking. Whatever our future ways of moving forward are, it’s crucial that people with lived experience – perspectives the mental health field has typically ignored – should be central to these efforts.”
Valtonen also believes the arts and humanities could lead to a more robust understanding of the human condition which can allow for a more nuanced view of the world and other people. He recently coauthored an article arguing the necessity of the arts and humanities in understanding mental health.
“Reading Chekhov will hardly solve anyone’s problems (especially economic ones) or make mental illness stigma disappear, but I think our questions regarding these and other challenges as a society would be wiser if our understanding of life were more informed by Chekhov than by the DSM.”
In terms of obstacles to the structural and systemic change that could help reduce stigma, Thiagarajan believes “the dominant ideology to challenge is individualism.” For Valdes “the main obstacles are power asymmetries within institutions, resource scarcity, and dominant cultural narratives that equate worth with productivity and self-reliance.”
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Valtonen, J., Azevedo, F., & Jost, J. T. (2026). Economic system justification predicts stigmatization of mental illness in the United States. American Psychologist. (Link)
