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Intersectionality and the Double Burden of Mental Health Stigma
By Carolyn Ball, LCPC

Mental health struggles affect millions worldwide, but for individuals from marginalized groups, these challenges are often amplified by the realities of intersectionality. Coined by legal scholar Kimberlé Crenshaw, the term “intersectionality” describes how social categories—such as race, gender, sexuality, class, and ability—intersect, creating overlapping systems of discrimination. When mental health stigma intersects with these social identities, it intensifies the barriers that marginalized individuals face.

For social work and mental health professionals, understanding intersectionality is vital in providing inclusive, compassionate care. Here, we’ll explore the connection between intersectionality and mental health stigma, offering insights on how professionals can better serve marginalized clients.

The Double Burden: Discrimination and Mental Health Stigma
Mental health stigma manifests as negative attitudes toward people experiencing mental illness or seeking mental health services. These attitudes often lead to judgment, shame, and social exclusion. For marginalized individuals, this stigma merges with other forms of discrimination based on race, gender, sexual orientation, socioeconomic status, or disability. This intersection creates a “double burden” that not only intensifies feelings of isolation and distress but also limits access to resources and support systems.

The fear of judgment from both their communities and health care professionals can discourage certain individuals from seeking help. In many cases, they may internalize the stigma, leading to a sense of hopelessness or self-blame for their struggles. As a result, untreated mental health conditions can worsen, contributing to a cycle of disengagement and marginalization.

Racial and Ethnic Minorities
For people of color, mental health stigma can be tied closely to systemic racism. Black, Latinx, and Indigenous populations frequently face health care disparities, biased diagnoses, and culturally insensitive care. According to the American Psychological Association, racial minorities are less likely to receive adequate mental health care, and more likely to encounter mistrust in the health care system due to historical traumas, such as the Tuskegee Syphilis Study.

In an intersectional context, a Black transgender woman may experience not only mental health stigma but also the compounded effects of racism, sexism, and transphobia. Her concerns may be dismissed, worsening the barriers to care.

LGBTQ+ Communities
LGBTQ+ individuals—particularly those from racial minorities—face higher rates of depression, anxiety, and other mental health issues with discrimination playing a role in their struggles. In fact, the National Alliance on Mental Illness reports that LGBTQ+ individuals are more than twice as likely as heterosexual adults to experience a mental health condition. For transgender individuals, finding culturally competent care can be especially challenging, as it can be compounded by experiences of violence and rejection.

Trauma and Intersectionality: Unique Mental Health Challenges
Trauma can affect anyone, but its impact is frequently intensified for people facing multiple layers of discrimination. For example, women of color are more likely to experience sexual violence, while Indigenous populations continue to grapple with historical trauma due to colonization.

Intersectionality helps us recognize that a Latinx woman coping with depression may also be navigating trauma linked to her immigration status or experiences of racial discrimination. Without this understanding, mental health professionals risk overlooking critical factors that shape her healing process.

Specialized trauma therapy in Chicago and other such diverse cities is increasingly adopting culturally sensitive practices to help clients process trauma within the context of their identities. This holistic approach fosters better therapeutic outcomes and stronger relationships between therapists and clients.

The Role of Social Workers
Social workers have a key role in supporting marginalized individuals. They must be aware of how discrimination and stigma shape the worldview of clients while offering interventions that align with these lived experiences to better foster trust and effectiveness.

Social workers also engage in advocacy efforts, working to dismantle barriers to mental health care by pushing for increased access to services, advocating for policy changes, and addressing discriminatory practices within the system.

To more effectively address intersectionality and stigma, social workers are encouraged to do the following:

• Stay informed on intersectionality’s impact on mental health by attending cultural competence workshops and trauma-informed care training.
• Create safe, nonjudgmental spaces where clients can share their experiences without fear of stigma.
• Tailor interventions to acknowledge the multiple layers of discrimination they encounter.
• Partner with medical, legal, and housing professionals to provide comprehensive support for clients whose needs intersect with multiple social systems.
• Advocate for systemic change by engaging in policy reform efforts to create more equitable mental health care systems.

Breaking Barriers Along the Path Toward Mental Health Equity
The intersection of mental health stigma and social discrimination creates significant challenges for marginalized individuals. By understanding and addressing these intersections, social workers can offer more equitable care.

Whether providing trauma therapy or engaging in advocacy efforts, it’s essential to adopt an intersectional, empathetic approach that acknowledges the complexity of each individual’s experience. Through this lens, mental health professionals can advance equity and dismantle the barriers that perpetuate stigma in our communities.

— Carolyn Ball, LCPC, is the founder of Elevate Counseling + Wellness. Her goal is to help people elevate their lives and reach their maximum potential. She has an understanding of the significance of mental health in a person's overall well-being, and is passionate about assisting others in living their best version of themselves. 

Resources
Oexle N, Corrigan PW. Understanding mental illness stigma toward persons with multiple stigmatized conditions: implications of intersectionality theory. Psychiatr Serv. 2018;69(5):587-589. https://psychiatryonline.org/doi/10.1176/appi.ps.201700312