Stigma is a major barrier to the life opportunities of people with disabilities, including those with psychiatric disabilities. Structural discrimination is stigma that results from social forces that develop over many years to diminish a group's resources and support needed to be successful. Affirmative action is a legal and political remedy to challenge structural stigma. To our knowledge, affirmative action per se has not been used to rectify the structures that block people with disabilities. Instead, progressive practices such as reasonable accommodations provide resources and support that create opportunities that rectify the injustices wrought by structural discrimination. Lessons learned in the United States about affirmative action and reasonable accommodation will demonstrate key points. Experiences of people with psychiatric disabilities will illustrate specific issues on structural discrimination. The paper ends with a discussion of the implications of these devices for diminishing the structural discrimination that corresponds with disabilities.