TY - JOUR
KW - Canada/epidemiology
KW - Community Health Centers
KW - Female
KW - Focus Groups
KW - Health Personnel/psychology
KW - Humans
KW - Interviews as Topic
KW - Male
KW - Mental Disorders/psychology/rehabilitation
KW - Qualitative Research
KW - Social Determinants of Health
KW - Social Discrimination
KW - Social Stigma
KW - Substance-Related Disorders/psychology/rehabilitation
KW - Canada
KW - mental illness
KW - Addiction
KW - Primary Health Care
KW - Recovery
KW - Stigma
AU - M. A. Murney
AU - J. C. Sapag
AU - S. J. Bobbili
AU - A. Khenti
A1 - 
AB - PURPOSE: Community Health Centres (CHCs) are an essential component of primary health care (PHC) in Canada. This article examines health providers' understandings and experiences regarding stigma towards mental health and substance use (MHSU) issues, as well as their ideas for an effective intervention to address stigma and discrimination, in three CHCs in Toronto, Ontario. METHODS: Using a phenomenological approach, we conducted twenty-three interviews with senior staff members and peer workers, and three focus groups with front-line health providers. Ahybrid approach to thematic analysis was employed, entailing a combination of emergent and a priori coding. RESULTS: The findings indicate that PHC settings are sites where multiple forms of stigma create health service barriers. Stigma and discrimination associated with MHSU also cohere around intersecting experiences of gender, race, class, age and other issues including the degree and visibility of distress. Clients may find social norms to be alienating, including behavioural expectations in Canadian PHC settings. CONCLUSIONS: Given the turmoil in clients' lives, systematic efforts to mitigate stigma were inhibited by myriad proximate factors that demanded urgent response. Health providers were enthusiastic about implementing anti-stigma/recovery-based approaches that could be integrated into current CHC services. Their recommendations for interventions centred around communication and education, such as training, CHC-wide meetings, and anti-stigma campaigns in surrounding communities.
AD - Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, Toronto, Canada.; Department of Community Health Sciences, Centre for Global Public Health, Max Rady College of Medicine, University of Manitoba, Canada.; WHO / PAHO Collaborating Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Canada.; Clinical Public Health Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Department of Public Health and the Department of Family Medicine, Pontificia Universidad Católica De Chile, Santiago, Chile.; WHO / PAHO Collaborating Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Canada.; WHO / PAHO Collaborating Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Canada.; Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
BT - International journal of qualitative studies on health and well-being
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 1
DO - 10.1080/17482631.2020.1744926
IS - 1
JF - International journal of qualitative studies on health and well-being
LA - eng
M1 - Journal Article
N2 - PURPOSE: Community Health Centres (CHCs) are an essential component of primary health care (PHC) in Canada. This article examines health providers' understandings and experiences regarding stigma towards mental health and substance use (MHSU) issues, as well as their ideas for an effective intervention to address stigma and discrimination, in three CHCs in Toronto, Ontario. METHODS: Using a phenomenological approach, we conducted twenty-three interviews with senior staff members and peer workers, and three focus groups with front-line health providers. Ahybrid approach to thematic analysis was employed, entailing a combination of emergent and a priori coding. RESULTS: The findings indicate that PHC settings are sites where multiple forms of stigma create health service barriers. Stigma and discrimination associated with MHSU also cohere around intersecting experiences of gender, race, class, age and other issues including the degree and visibility of distress. Clients may find social norms to be alienating, including behavioural expectations in Canadian PHC settings. CONCLUSIONS: Given the turmoil in clients' lives, systematic efforts to mitigate stigma were inhibited by myriad proximate factors that demanded urgent response. Health providers were enthusiastic about implementing anti-stigma/recovery-based approaches that could be integrated into current CHC services. Their recommendations for interventions centred around communication and education, such as training, CHC-wide meetings, and anti-stigma campaigns in surrounding communities.
PY - 2020
SN - 1748-2631; 1748-2623; 1748-2623
SP - 1744926
T1 - Stigma and discrimination related to mental health and substance use issues in primary health care in Toronto, Canada: a qualitative study
T2 - International journal of qualitative studies on health and well-being
TI - Stigma and discrimination related to mental health and substance use issues in primary health care in Toronto, Canada: a qualitative study
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 32228393
U3 - 10.1080/17482631.2020.1744926
VL - 15
VO - 1748-2631; 1748-2623; 1748-2623
Y1 - 2020
Y2 - Dec
ER -