The Role of Emotionality Stigma in Adolescent Mental Health: Measure Development and Call for Systems-Level Change

Youth mental health concerns, including substance abuse, continue to rise. With high co-morbidity rates and a marked lack of representation from diverse groups in study conceptualization, measurement, and implementation, efforts to understand factors impacting youth mental health from a cultural lens are needed. The theory of emotionality stigma posits that many mental health concerns can be understood based on one's endorsement of emotionality stigma-the experience of stigma around emotions-which manifests within one's context. Informed by this theory, the current study aimed to adapt and test a measure of emotionality stigma for diverse youth in combined mental health and substance use treatment. Targeted youth focus groups informed the adaptation of the pre-existing Emotionality Stigma Scale for implementation with diverse youth. Using a mixed methods approach, this measure was then tested for relevance, reliability, and validity in an outpatient youth clinic. Patients (N = 58, aged 13 to 21) reported their emotionality stigma, values, and attachment as part of routine monitoring. Based on qualitative feedback and quantitative analysis, our results illustrate the reliability and validity of the adapted Emotionality Stigma Scale and the relevance of this new measure for assessing youth mental health concerns and treatment outcomes. Areas for continued research are identified, and recommendations for implementation in conceptualization and treatment are provided.