Dr. Aderonke Pederson, an assistant professor of psychiatry at Harvard Medical School and a psychiatrist in the Depression Clinical and Research Program at Massachusetts General Hospital, joins the JCP Podcast to discuss how contact-based storytelling can function as a clinical intervention for reducing mental illness stigma and medical mistrust.

Stigma and mistrust are measurable barriers that delay care-seeking and worsen outcomes, particularly among Black adults with moderate to severe depression or anxiety who are not currently engaged in mental health services. Dr. Pederson walks through the theoretical foundations of contact-based stigma reduction, her research on religiosity and heterogeneity within Black communities, and a self-administered, video-based mobile intervention now being tested in a randomized controlled trial to help close the engagement gap in primary care.

🎯 KEY EPISODE HIGHLIGHTS:

🧩 STIGMA AS A FUNDAMENTAL CAUSE OF HEALTH INEQUITIES [04:00]

“Stigma has been described as a fundamental cause of health inequities.”

Framing stigma this way means it remains a barrier to care even after every other access issue has been addressed.

🧬 WHY MEDICAL MISTRUST IS AN EXPECTED RESPONSE [05:30]

“We expect mistrust if we have historical factors that have led to that mistrust.”

Clinicians should validate and address the historical roots of mistrust before working to reduce it.

🗣️ NAMING STIGMA TO GET IT OUT OF THE ROOM [53:00]

“It's in the room with you, and the question is, do you acknowledge its presence?”

Recognizing stigma and mistrust as active forces in every clinical encounter is the first step to addressing them with patients.

CHAPTERS:

00:00 – Introduction: When Story Becomes Clinical Intervention

03:30 – Stigma as a Fundamental Cause of Health Inequities

07:30 – From Basic Science to Psychosocial Mechanism: Where Stigma Intervenes

12:00 – The Engagement Gap: Disparities in Depression and Anxiety Care

16:00 – Religiosity and the Limits of Past Contact on Future Stigma

19:30 – Beyond Racial Categories: Heterogeneity and Migration

23:30 – The Power of Story: Why Narrative Changes Behavior

27:30 – Contact Theory: From Allport to the Psychiatric Ward

33:00 – Fisher's Narrative Paradigm and the Neuroscience of Story

36:30 – Shared Identity vs. Story Content

39:00 – Designing the App: A User-Centered Approach

45:00 – Inside the Clinical Trial: Reaching a Hard-to-Enroll Population

49:00 – Primary Endpoints and the Question of Durability

52:30 – Closing Thought: Naming Stigma to Address It

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep19-turning-stigma-into-stories-hope-aderonke-pederson/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Aderonke Pederson - LinkedIn

https://www.linkedin.com/in/aderonke-bamgbose-pederson-85345315/

#MentalHealthStigma #MedicalMistrust #HealthDisparities #DigitalTherapeutics #BlackMentalHealth