Justin Ray in AJMC on Stigma, Diagnosis & Crisis Care

Justin Ray, MSN, PMHNP-BC, founder of South Chesapeake Psychiatry and Transforming Minds Interventional Psychiatry, is the featured clinical voice in a new article from The American Journal of Managed Care (AJMC). Written by Habiba Atta for World Mental Health Day 2026, whose theme this year was lived experience, the piece asks why so many people with serious mental illness still go without care, and looks at three barriers in particular: stigma, diagnoses that are missed or delayed, and the drop-off in support after a crisis.

Read the article on AJMC.com →

What the Article Covers

• Stigma that gets the facts backwards. Public conversation still ties schizophrenia and bipolar disorder to violence. The article cites research pointing the other way: people living with these conditions are more likely to be victims of violence than to commit it. Justin’s point is a simple one. Most people with these diagnoses are not violent, and they deserve the same compassion and treatment as anyone with any other illness. Related: Rethinking Schizophrenia: When Cognition Drives the Bus.
• Why diagnoses get missed. Stigma shapes what people are willing to tell a clinician, and many share more only once trust has been built. Justin describes the three ways a diagnosis slips through: the right question is never asked, the answer is missed, or the client does not share it. Bipolar disorder is the classic example. The article cites a large national cohort study with an average delay of about six and a half years from first symptoms to diagnosis, often because a depressive episode is treated as ordinary depression. Learn how we approach bipolar disorder evaluation and treatment in Chesapeake, or read Bipolar Disorder vs. Borderline Personality Disorder.
• Brief screening tools help. Justin recommends short, validated screeners such as the Mood Disorder Questionnaire and the Rapid Mood Screener to catch bipolar disorder sooner, because the wrong treatment can make the illness worse and the consequences compound: lost jobs, strained relationships, hospitalization. Our free screening tool includes the Mood Disorder Questionnaire alongside screens for depression, anxiety, ADHD, and PTSD.
• The gap after a crisis. Emergency departments and crisis centers respond right away, but what comes next often does not. Justin describes follow-up appointments that take weeks to months, and the practical obstacles that make them harder to keep: unstable housing, no transportation, no phone. The article pairs this with data on how often people have to go out of network for behavioral health care, and on the states where Medicaid still does not pay for adult peer support. Justin talks about this same gap, from the ACT team side, on the Holding It Together (Kinda) podcast.
• What would help. Better access, real care coordination, and family involvement. Relatives are often the first to notice when a client’s account does not match what is happening at home. Justin has written about what it feels like to be on the receiving end of a system that does not call back, and why that shapes how we treat every client, in The Importance of Client Advocacy: A Personal Experience.
• An illness, not a character flaw. Justin closes the article with the comparison he makes often: mental illness is no different from diabetes. It is an illness, it is treatable, and recovery is possible.

South Chesapeake Psychiatry provides unhurried psychiatric evaluations and ongoing medication management for children, adolescents, and adults, including care for bipolar disorder and other serious mental illnesses. You can schedule an appointment online. Justin writes about access to care, new treatments, and the science behind them every week in The Neuropsychiatry Brief on LinkedIn, and recently discussed bipolar disorder on KY3’s Mindful Monday. Read the full article on AJMC.com.

If you or someone you know is in crisis, call or text 988 (Suicide & Crisis Lifeline), or call 911 in an emergency.