Mental health stigma and legal responses to defendants with mental health conditions in Bulgaria, Japan, and Norway

Front Psychol. 2026 May 5;17:1801646. doi: 10.3389/fpsyg.2026.1801646. eCollection 2026.

ABSTRACT

This article investigates, from a legal perspective, how criminal justice systems in Bulgaria, Japan, and Norway produce mental health stigma in their legal responses to defendants with mental health conditions. Although these countries operate within distinct legal traditions and cultural contexts, they all employ special rules on criminal responsibility and special preventive measures for this group of defendants. These rules and their application in legal practice may produce stigma through the association of legal notions, such as insanity and dangerousness, with psychiatric notions of mental disorders. Moreover, in all three countries the systems for the treatment and societal re-integration of defendants subjected to special preventive measures give rise to issues of separation and structural stigma. Our investigation indicates that there are profound challenges in all three countries, but that the pathways for stigma differ. In Japan and Bulgaria, societal stigma seems to interact with legal frameworks within a collectivistic culture in ways that disadvantage defendants with mental health conditions, while in Norway stigma appears to be more subtly embedded in risk-focused policies despite strong welfare structures. Importantly for further research however, our comparative discussion suggests that stigma in this context is not merely a cultural by product but is actively produced and reinforced through legal categories, practices, and policy choices. The findings highlight the need for legal reform focused on modernising legal terminology, mitigating discriminatory associations between legal and psychiatric constructs, and strengthening community-based pathways for treatment and reintegration.

PMID:42164802 | PMC:PMC13183534 | DOI:10.3389/fpsyg.2026.1801646