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<p>Rights-based mental health is increasingly prioritised globally, yet implementation varies across settings. This commentary proposes worth orientations as a cultural lens for explaining this variation: effort-based worth (human value legitimised through striving) and dignity-based worth (value grounded in inherent dignity). Worth orientations are positioned as a potential indicator of “rights-readiness” and linked to internal, external, and associative/social-reputational stigma. Effort-based worth is expected to amplify blame–shame stigma and reduce perceived deservingness, weakening engagement with rights-based support. Dignity-based worth should reduce moralised stigma and strengthen entitlement to care, although threat-based stereotypes may persist. A brief two-factor scale is outlined to support empirical testing and implementation evaluation.</p>

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Worth Orientations and Mental Health Stigma: Linking Effort-Based and Dignity-Based Worth to Rights-Based Practice

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月13日

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  • Yasuhiro Kotera

摘要

Rights-based mental health is increasingly prioritised globally, yet implementation varies across settings. This commentary proposes worth orientations as a cultural lens for explaining this variation: effort-based worth (human value legitimised through striving) and dignity-based worth (value grounded in inherent dignity). Worth orientations are positioned as a potential indicator of “rights-readiness” and linked to internal, external, and associative/social-reputational stigma. Effort-based worth is expected to amplify blame–shame stigma and reduce perceived deservingness, weakening engagement with rights-based support. Dignity-based worth should reduce moralised stigma and strengthen entitlement to care, although threat-based stereotypes may persist. A brief two-factor scale is outlined to support empirical testing and implementation evaluation.