Book Review: Radical empathy: Finding a path to bridging racial divides

the axes of risks for mental health stigma (such as being racially minoritized, female gendered, largebodied, living in a devalued neighborhood, or belonging to a marginalized or disadvantaged social group) do not act alone (p. 185), and they call for a new agenda to minimize mental health stigma that replaces the “emphasis on public education that has been favored in the past” with the “identif[ication] and creat[ion] of social roles in which people with mental illnesses can contribute to and participate in society and the economy” (p. 169). Brewis and Wutich end the book with an important message: “stigma should not be used in any way, for any reason, to promote public health” (p. 187) and, relatedly, “shame in all its forms needs to be removed from the public health tool kit” (p. 188). The authors provide a multistep approach to addressing stigma in global health that includes (1) increasing practitioner’s awareness of stigma and the way it manifests in health; (2) tracking the nature and depth of stigma experiences, the systems and mechanisms that create and perpetuate stigma, the ways in which stigma reinforces or generates inequalities and injustices, and the ways in which those who are stigmatized find hope and improve their lives; and (3) connecting the evidence to policy. Brewis and Wutich’s invitation to focus on systemic approaches to preventing and undoing stigma in global health—for example, interventions and policies focused on adequate provision of water and sanitation for all (hygiene), better access to public transportation (obesity), and creation and identification of social roles where people with mental illness are valued (mental illness)—is refreshing. In their efforts to shift the narrative away from individual-level public health approaches and, relatedly, the shaming and stigmatization of marginalized individuals and communities, however, Brewis and Wutich do seem to minimize the importance of individual-level efforts to undo stigma in our own lives and direct spheres of influence. There is an important balance to be struck that both recognizes systemic-level intervention while not minimizing the role that individuals play in perpetuating stigma —one that also highlights how we, individually and collectively, can work toward destigmatization in global health. It is not an oversight in the book but an area for future work in this field. Overall, this is a social justice–informed and critically important book for students, scholars, professionals, and policy makers in public health, medical anthropology, health-related social work, and health justice.