When Stigma Wears a White Coat: Facing Bias in Mental Health Care

By Katrin I. Kutlucinar, MA, LCPC, LPC

Stigma in mental health doesn’t always come from the public — it can also come from within the very systems meant to provide care. For individuals living with severe mental illnesses (SMI), such as bipolar disorder, schizophrenia, or schizoaffective disorder, encounters with stigma or bias from healthcare professionals can be deeply discouraging and even harmful. When patients sense that their symptoms or diagnoses are misunderstood, minimized, or judged, it can erode trust and prevent them from seeking the care they need.

As both a therapist and researcher specializing in SMI, I’ve seen how stigma in healthcare settings can affect outcomes. Yet I’ve also seen patients develop powerful tools to advocate for themselves, educate others, and foster better therapeutic relationships.

Here’s how individuals living with severe mental illness can navigate these challenges—and, in some cases, help create change in the process:

1. Know That Bias Is a Systemic Problem—Not a Personal Failure

Stigma among healthcare providers is not about anything you did—it often reflects insufficient training and systemic gaps in clinician education. Multiple studies show negative attitudes, pessimism about recovery, and social distancing toward individuals with psychotic disorders even among physicians, nurses, and general practitioners (Kruse & Dodell Feder, 2025).

When you encounter bias—whether it’s disbelief, dismissiveness, or condescension—it’s important to remember that the problem lies within the system, not within you. Reframing these experiences can help protect your sense of self-worth and resilience.

2. Bring a Support Person to Appointments

Having a trusted family member, friend, or advocate present during medical or psychiatric appointments can help ensure your concerns are heard. A support person can clarify information, take notes, and help validate your experiences if you sense bias or misunderstanding.

This approach can also deter unintentional bias—clinicians are often more thoughtful and attentive when another person is present. Studies suggest that personal contact with individuals with SMI can improve empathy and reduce stigmatizing attitudes among healthcare trainees and professionals (Masedo Gutiérrez & Martinez, 2025).

3. Learn—and Use—Your Rights

You have the right to fair, respectful, and non-discriminatory care. If you feel that your concerns are being dismissed or that you are being treated unfairly because of your diagnosis, consider:

• Requesting a different provider or a second opinion

• Asking for documentation of decisions or recommendations made during your visit

• Contacting a patient advocate or ombudsman at the facility

• Reporting discrimination to licensing boards or civil-rights offices if necessary

Knowledge of your rights is empowering—and it can also help shift power dynamics that too often leave patients feeling unheard.

4. Keep a Record of Your Care

Maintaining a personal health journal—including notes from appointments, medication changes, or any dismissive or concerning comments—can help you advocate for yourself later, especially if you switch providers.

For individuals with SMI like bipolar disorder or psychosis, documentation can also help track triggers, symptom patterns, medication effects, and overall progress. Having a record helps you maintain continuity of care and ensures that new providers can review your history thoughtfully.

5. Educate When You Have the Energy

It’s not your responsibility to teach your healthcare provider—but sharing accurate information about your experience can sometimes shift perspectives. Simple statements such as:

“Many people assume bipolar disorder means only mood swings, but it’s much more complex.” “With proper support and care, people living with schizophrenia or bipolar disorder can lead stable, meaningful lives.”

These statements humanize your experience and challenge stereotypical assumptions. Even small educational moments can help change mindsets over time.

6. Seek Out Clinicians Who Specialize in SMI

When possible, look for providers trained in evidence-based treatments for serious mental illness—therapies like Family-Focused Therapy for Bipolar Disorder (FFT-BD), Cognitive Behavioral Therapy for Psychosis (CBT-p), or Interpersonal and Social Rhythm Therapy (IPSRT). Research shows that one major factor in provider stigma is lack of knowledge or confidence in working with SMI (Masedo Gutiérrez & Martinez, 2025). Clinicians with specialized training are more likely to approach treatment with empathy, competence, and hope—crucial factors for positive outcomes.

7. Recognize the Impact of Stigma on Health & Recovery

Stigma isn’t just social—it has real health consequences. Research shows that stigma toward SMI leads to poorer quality of care, reduced access to services, delays in treatment seeking, and worse overall health outcomes (Stone et al., 2019).

Internalized stigma, or “self-stigma,” can hurt self-esteem, reduce motivation, and discourage people from pursuing or continuing treatment (Amsalem et al., 2023). Recognizing the systemic nature of stigma can help you externalize blame—it’s not about you; it’s about larger misunderstandings and prejudice.

8. Choose Empowerment Over Shame

Finally—and most importantly—you are not defined by your diagnosis. Bias and stigma are external forces, but they do not determine your worth or your future. You deserve dignity, respect, and access to care that supports healing and growth.

Building a life that reflects your values—through therapy, self-education, connection, and strength—sends a powerful message. By living authentically and advocating for yourself, you challenge bias and model recovery for providers, other patients, and communities.

As someone who has both clinical and research experience—and deep personal commitment to this work—I stand with you. The best response to stigma is thriving on your own terms.

References

 

Chen, J., El-Den, S., Pham, L., O'Reilly, C. L., & Collins, J. C. (2023). Healthcare professionals' knowledge, confidence and attitudes in relation to psychosis care: A systematic review. Int J Soc Psychiatry, 69(8), 1856-1868. https://doi.org/10.1177/00207640231194490

Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest, 15(2), 37-70. https://doi.org/10.1177/1529100614531398

Kruse, E. A., & Dodell-Feder, D. (2025). Schizophrenia spectrum stigma in healthcare: a systematic review. Front Psychiatry, 16, 1648957. https://doi.org/10.3389/fpsyt.2025.1648957

Kruse, E. A., & Dodell-Feder, D. (2025). Schizophrenia spectrum stigma in healthcare: a systematic review [Systematic Review]. Frontiers in Psychiatry, Volume 16 - 2025. https://doi.org/10.3389/fpsyt.2025.1648957

Masedo Gutierrez, A. I., & Martinez, G. C. (2025). Stigma Toward Severe Mental Illness Among Healthcare Students: A Qualitative Study. Int J Environ Res Public Health, 22(3). https://doi.org/10.3390/ijerph22030333

Pescosolido, B. A., Halpern-Manners, A., Luo, L., & Perry, B. (2021). Trends in Public Stigma of Mental Illness in the US, 1996-2018. JAMA Netw Open, 4(12), e2140202. https://doi.org/10.1001/jamanetworkopen.2021.40202

Stone, E. M., Chen, L. N., Daumit, G. L., Linden, S., & McGinty, E. E. (2019). General Medical Clinicians' Attitudes Toward People with Serious Mental Illness: A Scoping Review. J Behav Health Serv Res, 46(4), 656-679. https://doi.org/10.1007/s11414-019-09652-w