Community Health Needs Assessment Theme 9: Stigma Has Changed, But Not for Everyone.
The ninth theme identified in our 2025 community health needs assessment is that stigma has changed, but is still present. Stigma refers to negative attitudes, beliefs, and stereotypes people may hold towards those who experience mental health conditions. According to providers, stigma reduction is a common goal of government and advocacy organizations to improve access to and use of mental and behavioral health care.
In our 2025 community health needs assessment, we heard 10 major themes impacting youth mental and behavioral health in St. Louis County. See them all and learn how we conducted this assessment.
Generational Differences.
There are generational differences in stigma, participants say. Older parents and grandparents raising children are called out for their lack of empathy. Sometimes they do not believe that mental health conditions can cause behavioral or academic problems; some parents are unwilling to discuss mental health.
In contrast, youth report very low or no reservations to discuss mental health. Educators describe most students as confident, comfortable, and able to describe feelings and mental health issues. Adults suggest the pandemic drove the cultural shift in stigma, noting national attention to the mental health needs of youth who were displaced from school. Youth offer a different explanation, citing how the internet provides easy access to information and other people who are experiencing similar feelings or situations. They credit social media with promoting mental wellness, encouraging therapy, and normalizing depression and anxiety via testimonials from friends as well as celebrities.
Historical and Ongoing Experiences.
Racial and ethnic norms play a significant role. Some racial and ethnic groups emphasize emotional toughness or the privacy of family matters. Historical and ongoing experiences of discrimination and marginalization from healthcare and education institutions shape how individuals and communities approach mental health. This can be especially true for immigrant families; see Section 4: Supplemental Findings in the full community health needs assessment report for additional information on perspectives shared in those groups.
Stigma in Adults Affects Children.
Stigma is consequential. An adult with stigma may block a child’s access to mental health services or suppress the child’s emotions. Children can adopt unhealthy coping strategies by living with these adults. While participants say harm caused by stigma has lessened over time, stigma still shapes the emotional environment in which children grow up
We spoke to more than 300 St. Louisans to understand what needs exist when it comes to youth behavioral health. Learn more about our process.