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

Abstract 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.