What is the issue?
In a health-care context, structural stigma occurs through the activities its organizations amass over time, which deliberately or inadvertently create and maintain social inequalities.
Structural stigma is especially damaging ꟷ and dangerous ꟷ for persons with lived and living experience of mental health problems and illnesses and/or substance use. Why? Because such stigma represents the unfairness and inequity embedded into the very fabric of our social institutions, organizations, and our shared ways of thinking and acting toward people facing these challenges.
What are we doing?
In 2019, we launched a project to better understand the problem of mental health- and substance use-related structural stigma in health care. Its overarching objective: to identify gaps and reduce stigma, both at policy, practice, and system levels and within the organizational culture of health care.
Our first year involved three main research activities:
- A comprehensive literature review , with key recommendations and suggested approaches
- A qualitative research project using focus groups consisting of people with lived experience to identify key priorities and areas for structural change within the health-care system
- An environmental scan to help guide the development of new measurement and audit tools for structural stigma
The findings across these three projects were overlapping and reinforcing. As a result, a comprehensive picture of structural stigma emerged: how it is experienced, how it impacts health and quality-of-life outcomes, and what are the most important strategies for reshaping the way health services are provided to persons with lived and living experience of mental health problems and illnesses and/or substance use.