Stigma, Self-Stigma, and Psychosocial Disability in Colombia: A longitudinal review of public policy, Institutional Recognition, and Lived Experience through the Lens of Pre-Policy, Certification Process, and Post-Pandemic Perspectives

Resumo

In Colombia, a country marked by armed conflict and deep social inequalities, stigma and perceptions of psychosocial disability critically influence access to rights and services. This qualitative study examines how these perceptions have evolved through a review of previous qualitative research. Organized around three key moments-the period prior to the implementation of the National Mental Health Policy, the disability certification process, and a recent participatory research initiative-the analysis identifies persistent tensions in institutional narratives and first-person accounts. The findings show a consistent gap between legal frameworks and lived experiences, particularly in indigenous and Afro-Colombian communities affected by violence. Although official policies promote inclusion and rehabilitation, they often fail to connect with local realities due to the persistence of stigma and discrimination, the effects of self-stigma on the subjective appropriation of rights, and the limited meaningful participation of persons with disabilities in key processes such as peacebuilding. Victims with disabilities face additional challenges that affect their mental health and restrict their social participation. While there have been institutional efforts to establish care pathways and guarantee rights, there remains limited understanding of how stigma and self-stigma have evolved - if at all - since the implementation of the National Mental Health Policy, as well as the impact of bureaucratic processes, such as certification, on subjective representations of disability. This analysis underscores the need for community strategies that consider cultural differences and confront structural and symbolic exclusion. The recent approval of the Mental Health Law 2025 represents a renewed opportunity to move forward, highlighting the importance of longitudinal and participatory monitoring to assess its impact on access, equity and social participation.