Mental Illness-Related Structural Stigma: The Downward Spiral of Systemic Exclusion Final Report

Increasingly, governments, non-governmental organizations, and private corporations in Canada and around the world are mobilizing resources towards preventing and addressing mental illness-related stigma. The Mental Health Strategy for Canada highlights the need to “fight stigma by including opportunities in promotion, prevention and early intervention initiatives to meet and talk with people living with mental health problems and illnesses” and to “review and, where necessary, update legislation and revise policies across jurisdiction and sectors to achieve alignment with the UN Convention on the Rights of Persons with Disabilities”. In addition, the Mental Health Commission of Canada initiated Opening Minds in 2009, which is a systematic effort to reduce stigma related to mental illnesses, with a specific emphasis on healthcare providers, youth, media, and the workforce. At the same time, many Canadian provinces and territories have released long-term mental health plans that identify stigma-reduction as a priority for action.

Across multiple life domains, people with mental illnesses must contend with arbitrary restrictions on their rights and opportunities—even in countries with advanced legislative protections against discrimination, such as Canada. Stigma cannot be eradicated without attending to structural stigma; that is, the inequities and injustices that are woven into the policies and practices of our institutional systems. Despite the dearth of empirical evidence about how to address mental illness-related structural stigma effectively, there is a robust body of knowledge offering brilliant ideas about the most promising methods for beginning to break down the structural barriers facing people with mental illnesses.

This report summarizes what is known about mental illness-related structural stigma. It begins with an overview of the concepts of stigma and structural stigma, including how they are understood by contemporary scholars. The report then outlines the different ways in which structural stigma manifests in modern institutional systems and social contexts, including: healthcare; employment and income; housing; education; criminal justice; privacy; public participation; travel and immigration; media; and reproduction and parenting. It is apparent there are few areas of social policy affecting people with mental illnesses that remain untainted by stigma. The final sections of the report synthesize the existing knowledge pertaining to addressing structural stigma. The most promising methods involve a combination of legal and policy action, advocacy, inclusive efforts, healthcare reform, education, and research.