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Structural Stigma


What is the issue?

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. While it often occurs unknowingly (through implicit cognitive biases), it expresses the inequities embedded in the fabric of our social institutions, organizations, and our shared ways of thinking and acting.

In health care, structural stigma occurs when laws, policies, and practices result in the unfair treatment of people with lived and [living] experience. Such unfairness leads to inequitable access and a lower quality of care for these individuals, whether their concerns relate to physical health, mental health, and/or substance use.

What are we doing?

In 2019, we launched a multi-year project to better understand the problem of mental health- and substance use-related structural stigma in health-care contexts. Its overarching objective: to identify gaps and reduce stigma, both at policy, practice, and system levels and within the organizational culture of health care.

What can you do?

Read our progress report to catch up on the latest. You can also deepen your knowledge with our key research, personal experience stories, prototypes, and real-world examples:

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  • Scaling up: Promising Practices
    • Learn from real-world examples and best practices to dismantle structural stigma:
      • Access our guide: Dismantling structural stigma in health care:  An implementation guide to making real change for and with people living with mental health problems or illnesses and/or substance use concerns. Learn about the latest strategies, tools, and resources to dismantle structural stigma. This implementation guide was created for and with people living with mental health and/or substance use concerns or illnesses to inspire real change. Be part of the solution and make a difference!
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  • Training
    • Structural Stigma in Health Care – Free online training to help you learn more about the impacts of structural stigma in health care and how to dismantle it (created in partnership with CHA Learning). The course focuses on structural stigma related to mental health problems or illnesses and substance use concerns and how it affects service users’ access and quality of care. This course is for health-care leaders at any level, health-care professionals seeking to improve quality of care, and anyone interested in learning about the impacts of structural stigma.
  •  Watch our webinar: In Toward Quality Mental Health Care: Dismantling Structural Stigma, health-care experts explore the stigma-free and inclusive dimension of the Quality Mental Health Care Framework, focusing on the crucial concept of structural stigma.


  • A comprehensive literature review, with key recommendations and suggested approaches
  • A qualitative research project using focus groups consisting of people with lived and living 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
  • Read the summary of our main findings on structural stigma in our Framework for Action.

  Silent Barriers: Understanding How We Can Dismantle Mental Health- and Substance Use-Related Structural Stigma in Health Care

Additional information