In 2025, Does Mental Health Stigma Still Exist?

I remember meeting a young mental health clinician some time back who had their own therapy practice. They asked what I did, and at the time I was working in a county hospital psychiatric emergency room (taking care of people with decompensated schizophrenia, suicide attempts, and cocaine and meth intoxication).

The therapist looked taken aback when I shared that. “Oh. Wow. Yeah, I don’t work with that kind of mental health.”

I started my career as a psychiatrist nearly ten years ago, and since then, mental health has become a much more commonplace topic; it has an awareness day, an awareness month, influencer campaigns, workplace conferences...

Yet that conversation has stayed with me because it highlights how, even among mental health clinicians, there can be a certain kind of pathology that’s a little too much. Patients who are too acute. Mental health conditions that are too severe.

When I think about the patients and stories I’ve encountered over these ten years, I would say yes–mental health stigma still exists.

In more recent times, if you say you’re in therapy, you’ll likely get a lot of knowing nods and positive feedback. Say you’re on an antidepressant, and you might get some of that, but potentially a little discomfort too. Say you’re on an antipsychotic (a class of medications used to augment treatment of depression, stabilize bipolar disorder, or manage symptoms of psychotic disorders)? There’s likely to be some immediate judgment.

The fact is there remain much more palatable topics within mental health: topics like well-being, mindfulness, resilience, burnout, and sustainability. These are mostly pleasant to talk about, with generally positive outcomes, unlike the more painful conversations about first-break psychosis in a medical student derailing their career, opioid use disorder after a loved one got prescribed pain pills and got completely hooked, or that the cause of death of a friend was actually suicide.

These topics are a little harder to digest, and I’d say we are still knee-deep in stigma especially when it comes to them–that “other kind of mental health.”

I think of mental health as being along a spectrum, and on one end are the severe presentations that require intensive treatment—higher levels of care like inpatient hospitalization or multiple medications to help mitigate symptoms. On the other hand is positive psychology and skill-building around fortifying mental health to help keep mostly-already-healthy people, healthy.

Both are necessary, but there’s a clear emphasis on one which I think is partially a function in part of the greater stigma of the other–when the more complex mental health topics are harder to touch, we focus on lower-hanging fruit. There’s also the “barrier to entry”, if you will, of opining on the more serious mental health disorders; these are things that corporate leaders and life coaches have little technical knowledge about and that require specialists to provide more education on.

Stigma is also setting-dependent. It may be much harder to talk about professional struggles impacting one’s mental health in the workplace, or personal struggles in a faith congregation. Even if one doesn’t have a mental health condition, to discuss those struggles may come with a vulnerability that doesn’t feel safe in a particular setting. For example, it may be welcome to talk about depression, but not about suicidal thoughts.

In my Desi community, where the prevailing thinking often is to keep struggles behind closed doors, stigma around mental health—especially more complex conditions—very much so continues to persist. And in my Muslim community, conditions like drug addiction can be seen purely as religious vices, while generalized anxiety disorder or major depressive disorder can be seen as crises of faith, rendering conversations about them especially challenging: when people are already struggling with mental health conditions, the last thing they want is to be ostracized from their community and deeper in their isolation, which can worsen internalized stigma.

The problem with how the stigma has been addressed, however, has perhaps in some ways backfired. Because of mental health conversations centering only general well-being, “feelings” have taken center stage, and I’ve been in settings in which just the mention of the phrase “mental health” now generates eye rolls. There’s also been an unfortunate corruption of language: everyone who behaves selfishly is a narcissist, everyone with a different opinion is gaslighting, being challenged means feeling unsafe—this mislabeling has undermined the credibility of legitimate concerns.

I think that pervading social media language and public awareness about mental health has only moved the needle so far. So while talking about mental health, learning about mental health, and working on our mental health all continue to help with the stigma, there’s far more to be done.

Here are a few shifts I hope to see in 2025:

• Focus on destigmatizing psychotropic medication, not only therapy (my paper years ago on how medications in particular were stigmatized in a Muslim-centered education program)

• Policy-level mental health changes (such as increased funding for mental health and improved access to care)

• Greater emphasis on the social and political determinants of mental health (socioeconomic status, adverse childhood events, capitalism and extreme individualism + wealth inequity)

• Formalized community education and skill-building (Mental Health First Aid for imams, for example)

I’d love to hear from you. What are your thoughts about mental health stigma?