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. 2025 Jan;33(1):109-129.
doi: 10.1177/10541373231201952. Epub 2023 Sep 24.

Understanding and Addressing Mental Health Disparities and Stigma in Serious Illness and Palliative Care

James Gerhart  1   2 , Laura Bouchard Oswald  3 , Laurie McLouth  4 , Lindsey Gibb  1 , Laura Perry  5 , Ashley Eaton England  1 , Timothy Sannes  6 , Delaney Schoenbine  7 , Katherine Ramos  8   9   10 , Jared Greenberg  11 , Sean O'Mahony  12 , Stacie Levine  13 , Aliza Baron  13 , Michael Hoerger  14
Affiliations

Understanding and Addressing Mental Health Disparities and Stigma in Serious Illness and Palliative Care

James Gerhart et al. Illn Crises Loss. 2025 Jan.

Abstract

Patients receiving palliative care experience stigma associated with their illness, personal identity, and healthcare utilization. These stigmas can occur at any stage of the disease process. Varying stigmas combine to cause palliative care patients to feel misunderstood, contribute to treatment barriers, and further negative stereotypes held by clinicians. Stigma surrounding palliative care patients stems from complex intersections of varied access to resources, familial and physical environment, socioeconomic status, mental health and disorders, and identity characteristics. This article examines the relationship between mental health stigma and palliative care through three pathways: stigma and barriers existing within healthcare, the tendency of this stigma to undermine social support, and the deferral of treatment-seeking in response to stigma. Recommendations to address and diminish stigmatization are presented, including advocacy, increased research and assessment, and contextual and intersectional awareness. Clinicians are also encouraged to turn to their colleagues for peer support and team-based care.

Keywords: mental health; palliative care; stigma.

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Figures

Figure. 1
Figure. 1
Individuals, stigma, and disparities are nested in social structures.
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