The human side of structural stigma: a call to action to address the lack of equity in mental health and substance use care

Author:

Howlett Megan,Grimminck RachelORCID

Abstract

Structural mental health and substance use (MHSU) stigma is a health equity and human rights issue that results in significant disparities in health outcomes for people with MHSU disorders. Two early career psychiatric physicians share the vicarious and witnessed experiences of their patients within the public mental health system, especially those deemed to be high risk. The authors also describe barriers patients face, and the unacceptable reality that mental health emergencies are systematically not handled as such, to the detriment of patient, family and provider well-being. Strategies to address structural MHSU stigma are also discussed with a particular emphasis on the emergency psychiatry context.

Publisher

BMJ

Subject

Strategy and Management,Health Policy,Leadership and Management

Reference18 articles.

1. Knaak S , Livingston J , Stuart H , et al . Combating mental illness- and substance use-related structural stigma in health care: A framework for action. Ottawa, Canada: Mental Health Commission of Canada, 2020.

2. Stuart H , Arboleda-Flórez J , Sartorius N . Paradigms lost: fighting stigma and the lessons learned. In: Paradigms Lost– Fighting stigma and the lessons learned. Oxford University Press, 10 June 2012. doi:10.1093/med/9780199797639.001.0001

3. Mental illness-related stigma in healthcare

4. Livingston JD . Structural stigma in health-care contexts for people with mental health and substance use issues: A literature review. Ottawa: Mental Health Commission of Canada, 2020.

5. The lancet Commission on ending stigma and discrimination in mental health;Thornicroft;Lancet,2022

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