Dismantling Structural Stigma Related to Mental Health and Substance Use: An Educational Framework

Abstract

Stigma related to mental health and substance use (MHSU) is a wellestablished construct that describes how inequitable health outcomes can result from prejudice, discrimination, and marginalization. Although there is a body of literature on educational approaches to reduce stigma, antistigma education for MHSU has primarily focused on stigma at the social, interpersonal/ public, and personal (self-stigma) levels, with little attention to the problem of structural stigma. Structural stigma refers to how inequity is manifested through rules, policies, and procedures embedded within organizations and society at

Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study

“…As such, the population with OUD and StUD is growing, and the health and substance use service needs of this population require increased attention. This may necessitate ongoing education for care providers [40], given people who use stimulants such as methamphetamine have been known to face stigma in their health care encounters [41][42][43] which can be compounded by concurrent mental illness [44].…”

Effects of the Communities that Heal (CTH) intervention on perceived opioid-related community stigma in the HEALing Communities Study: results of a multi-site, community-level, cluster-randomized trial

“…Perceptions of community stigma are an important contributor to structural stigma 8 that is manifested in local policies, institutional practices, and cultural norms that inhibit the availability, access, use, and public support of harm reduction, prevention and treatment services. 9 Structural stigma may be difficult to measure, and the General Social Survey (GSS) has functioned as the preferred indicator of structural stigma in the US. 10 However, the GSS provides national estimates and does not yield local, community-specific indicators of stigmatising attitudes, nor does it include measures specific to people with OUD or EBPs for OUD.…”

Factors associated with the stigmatization of psychoactive substance users among Latin American health professionals.

“…The scientific literature suggests that strategies focused on education, contact, and protest would be effective in reducing stigma because they are low-cost interventions that aim to generate interpersonal, social, and structural changes (National Academies of Sciences, Engineering, and Medicine, 2016; Sukhera et al, 2022). Although evidence shows that brief educational interventions targeting specific groups can have positive impacts on increasing knowledge about stigma and producing favorable attitudes and behaviors (Gronholm et al, 2017) and that participation and contact techniques may be useful to promote social inclusion practices (Ritterbusch, 2016), there is still no strong evidence to indicate that such interventions are completely effective in reducing stigma among health professionals (Tostes et al, 2020).…”