Combating Mental Illness and Substance Use Related Structural Stigma in Health Care – A Framework for Action

In 2019, the Mental Health Commission of Canada (MHCC) launched a program to better understand the problem of mental illness- and substance use-related structural stigma in health-care environments. The first year of this program involved the completion of three main research projects:

• a comprehensive literature review
• a qualitative research study based on focus groups consisting of people with lived and living experience of mental health problems and illnesses and/or substance use (forthcoming)
• an environmental scan to assess the need for tools that measure structural inequities in mental illness- and substance use-related care

This research brought into focus a comprehensive picture of structural stigma in health-care environments: how it is experienced, how it impacts health and quality-of-life outcomes, and how we might reshape the way health service delivery and care are provided to persons with lived experience. The main findings were synthesized into seven priorities for dismantling and disrupting structural stigma in health care (see Figure 1).

These findings were further summarized in an expanded version of the Action Framework for Building an Inclusive Health System fact sheet from The Chief Public Health Officer’s Report on the State of Public Health in Canada. This action framework will be useful for guiding future research, interventions, and initiatives by organizations committed to improving.