Mental Health Commission of Canada guide to dismantling structural stigma

Structural stigma creates real barriers for people with mental health or substance use (MHSU) problems who are trying to access quality health care. To help healthcare organizations dismantle structural stigma, the Mental Health Commission of Canada (MHCC) called on Ascribe to write a comprehensive guide filled with practical tips and advice.

How Ascribe helped

Stigma affects how we see and treat people living with MHSU problems. When it becomes embedded throughout a system or institution, it becomes structural stigma. In 2019, the MHCC launched a multi-year project to better understand MHSU-related structural stigma in healthcare settings.

As part of that project, in 2022, the MHCC hosted a two-day virtual workshop with representatives from six “champion and changemaker” healthcare organizations — those that have shown promise in improving access to and quality of care for people living with MHSU problems — to identify barriers, facilitators and promising practices for reducing structural stigma. A member of the Ascribe team attended this event, taking notes to produce a summary report of the discussions.

The feedback heard at these workshops would go on to form the foundation for a comprehensive guide, also written by Ascribe, that provides healthcare leaders and providers with practical tips and tools they can implement to reduce MHSU-related structural stigma within their organizations. Our team began by presenting two creative approaches for the guide, describing at a high level how the content could be structured and arranged. After the MHCC selected one of the approaches, we then developed a detailed content outline for each of the core sections of the guide.

We supplemented the workshop feedback with fresh insights and perspectives gathered through a set of interviews conducted in late 2022 and early 2023 with the six “champion and changemaker” organizations. In these sessions, our team probed deeper into the practical steps they took to dismantle structural stigma and the outcomes they achieved — and how those outcomes might be replicated by other organizations across the country.

The final version of the implementation guide, Dismantling structural stigma in health care, was posted to the MHCC website in 2023. A total of 100 pages in layout (designed by our longtime partner, Accurate Creative), the guide presents 11 steps for addressing structural stigma, with each section featuring key principles, real-world success stories, reflection and discussion questions, and additional tools and resources.

Deliverable: Implementation Guide

Our process:

• Event coverage and reporting
• Background material review
• Creative approaches
• Questionnaire development
• Content-gathering interviews with healthcare organizations
• Detailed content outline
• Writing and revisions