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

Area of Science:

• Health Professions Education
• Public Health
• Social Determinants of Health

Background:

• Stigma related to mental health and substance use (MHSU) contributes to health inequities.
• Existing anti-stigma education often overlooks structural stigma, which is embedded in policies and organizational practices.
• Structural stigma impacts clinical learning environments and patient care.

Purpose of the Study:

• To propose a framework for addressing structural MHSU stigma in health professions education.
• To introduce structural competency as an educational approach to combat structural stigma.
• To enhance health professionals' ability to recognize and address social and structural determinants of health disparities.

Main Methods:

• A proposed framework with 4 key components rooted in structural humility.
• Focus on recognizing structural stigma, critical self-reflection, reframing language, and actionable dismantling of stigma.
• Application of structural competency within clinical learning environments.

Main Results:

• The framework provides a structured approach to address structural MHSU stigma.
• Structural competency enhances recognition and response to structural determinants of health.
• Educational interventions can dismantle structural stigma in healthcare settings.

Conclusions:

• Addressing structural MHSU stigma through education is crucial for improving health equity.
• A framework based on structural humility offers a practical approach for health professions education.
• Implementing structural competency can lead to more equitable care and dismantle systemic inequities.