"They Don't Know Me, Except That I'm Crazy": Psychiatric Patients' Perceptions of Research Participation and Stigma.

OBJECTIVE: The authors sought to identify barriers to participation in psychiatric research, especially for members of racial-ethnic minority groups, and applied a community engagement model to identify strategies to improve trust in science and research participation among individuals with psychiatric or substance use disorders. METHODS: Using the Bridging Research, Accurate Information, and Dialogue (BRAID) model as a framework, the authors conducted 10 cofacilitated conversation circles with 15 adults with psychiatric or substance use disorder diagnoses across three clinical and community-based sites in New York. Thematic analysis was used to identify key barriers to research participation and community-informed strategies for engagement. RESULTS: Participants described a deep mistrust of psychiatric research and behavioral health care that was rooted in histories of harm, a lack of shared decision making, and provider stigma. Stigma and discrimination-particularly during emergency and pain-related visits-were pervasive and compounded by participants' racial-ethnic, economic, and diagnostic groups. Participants endorsed the conversation circles as safe, empowering spaces. CONCLUSIONS: Lack of trust, stigma, and discrimination continue to deter minoritized patients' engagement in psychiatric research. Community-driven models, such as BRAID, offer a promising pathway to rebuild trust; amplify patients' voices; and promote ethical, equitable research and services.