Mental Illness-related Stigma in Healthcare: Barriers to Access and Care and Evidence-based Solutions

Overview

Journal Healthc Manage Forum

Specialty Health Services

Date 2017 Sep 21

PMID 28929889

Citations 317

Authors

Stephanie Knaak

Ed Mantler

Andrew Szeto

Affiliations

Soon will be listed here.

Abstract

Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

Citing Articles

Psychedelic-Assisted Therapy Training: An Argument in Support of Firsthand Experience of Nonordinary States of Consciousness in the Development of Competence.

Dames S, Watler C, Kryskow P, Allard P, Gagnon M, Taylor W Psychedelic Med (New Rochelle). 2025; 2(3):130-137.

PMID: 40051685 PMC: 11658659. DOI: 10.1089/psymed.2023.0004.

How are motivational interviewing techniques associated with US healthcare employees' mental health help-seeking behaviours when using the interactive screening programme.

Frey J, Deng Y, Osteen P, Imboden R, Mosby A, Ware O BMJ Public Health. 2025; 2(2):e001293.

PMID: 40018600 PMC: 11816209. DOI: 10.1136/bmjph-2024-001293.

Competence required while caring for people living with mental illness in the ambulance care setting: a Delphi study.

Holmberg M, Hammarback S, Andersson H Discov Ment Health. 2025; 5(1):17.

PMID: 39982566 PMC: 11845652. DOI: 10.1007/s44192-025-00140-6.

Group and partnered dance for people living with dementia: an overview of intervention design and measurement considerations.

Jehu D, Bek J, Bennett C, Hackney M Front Psychol. 2025; 16:1500688.

PMID: 39950072 PMC: 11821603. DOI: 10.3389/fpsyg.2025.1500688.

Exploring Health-Seeking Behaviors Among Healthcare Workers and the General Population During the COVID-19 Pandemic: A Retrospective Quantitative Study.

Castaneda-Millan G, Haritos A, Formuli E, Mazur M, Balakrishnar K, Stephanie Long B Health Serv Insights. 2025; 18:11786329251316698.

PMID: 39917358 PMC: 11800249. DOI: 10.1177/11786329251316698.

References

Hamilton S, Pinfold V, Cotney J, Couperthwaite L, Matthews J, Barret K . Qualitative analysis of mental health service users' reported experiences of discrimination. Acta Psychiatr Scand. 2016; 134 Suppl 446:14-22. PMC: 6680261. DOI: 10.1111/acps.12611. View

Jones S, Howard L, Thornicroft G . 'Diagnostic overshadowing': worse physical health care for people with mental illness. Acta Psychiatr Scand. 2008; 118(3):169-71. DOI: 10.1111/j.1600-0447.2008.01211.x. View

MacCarthy D, Weinerman R, Kallstrom L, Kadlec H, Hollander M, Patten S . Mental health practice and attitudes of family physicians can be changed!. Perm J. 2013; 17(3):14-7. PMC: 3783077. DOI: 10.7812/TPP/13-033. View

Leucht S, Burkard T, Henderson J, Maj M, Sartorius N . Physical illness and schizophrenia: a review of the literature. Acta Psychiatr Scand. 2007; 116(5):317-33. DOI: 10.1111/j.1600-0447.2007.01095.x. View

Dewa C, Lesage A, Goering P, Craveen M . Nature and prevalence of mental illness in the workplace. Healthc Pap. 2005; 5(2):12-25. DOI: 10.12927/hcpap..16820. View

Corrigan P, Druss B, Perlick D . The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest. 2015; 15(2):37-70. DOI: 10.1177/1529100614531398. View

Knaak S, Modgill G, Patten S . Key ingredients of anti-stigma programs for health care providers: a data synthesis of evaluative studies. Can J Psychiatry. 2015; 59(10 Suppl 1):S19-26. PMC: 4213748. DOI: 10.1177/070674371405901s06. View

Edlund M, Wang P, Berglund P, Katz S, Lin E, Kessler R . Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. Am J Psychiatry. 2002; 159(5):845-51. DOI: 10.1176/appi.ajp.159.5.845. View

Schulze B . Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry. 2007; 19(2):137-55. DOI: 10.1080/09540260701278929. View

10.

Agrawal S, Capponi P, Lopez J, Kidd S, Ringsted C, Wiljer D . From Surviving to Advising: A Novel Course Pairing Mental Health and Addictions Service Users as Advisors to Senior Psychiatry Residents. Acad Psychiatry. 2016; 40(3):475-80. DOI: 10.1007/s40596-016-0533-z. View

11.

Sansone R, Sansone L . Responses of mental health clinicians to patients with borderline personality disorder. Innov Clin Neurosci. 2013; 10(5-6):39-43. PMC: 3719460. View

12.

Knaak S, Patten S, Ungar T . Mental illness stigma as a quality-of-care problem. Lancet Psychiatry. 2015; 2(10):863-4. DOI: 10.1016/S2215-0366(15)00382-X. View

13.

Knaak S, Ungar T, Patten S . Seeing is believing: Biological information may reduce mental health stigma amongst physicians. Aust N Z J Psychiatry. 2015; 49(8):751-2. PMC: 4519522. DOI: 10.1177/0004867415584643. View

14.

Barrett M, Chua W, Crits-Christoph P, Gibbons M, Casiano D, Thompson D . EARLY WITHDRAWAL FROM MENTAL HEALTH TREATMENT: IMPLICATIONS FOR PSYCHOTHERAPY PRACTICE. Psychotherapy (Chic). 2011; 45(2):247-267. PMC: 2762228. DOI: 10.1037/0033-3204.45.2.247. View

15.

Ungar T, Knaak S, Szeto A . Theoretical and Practical Considerations for Combating Mental Illness Stigma in Health Care. Community Ment Health J. 2015; 52(3):262-71. PMC: 4805707. DOI: 10.1007/s10597-015-9910-4. View

16.

Stuart H, Chen S, Christie R, Dobson K, Kirsh B, Knaak S . Opening minds in Canada: background and rationale. Can J Psychiatry. 2015; 59(10 Suppl 1):S8-S12. PMC: 4213755. DOI: 10.1177/070674371405901s04. View

17.

Moutier C, Cornette M, Lehrmann J, Geppert C, Tsao C, DeBoard R . When residents need health care: stigma of the patient role. Acad Psychiatry. 2009; 33(6):431-41. DOI: 10.1176/appi.ap.33.6.431. View

18.

Wallace J . Mental health and stigma in the medical profession. Health (London). 2010; 16(1):3-18. DOI: 10.1177/1363459310371080. View

19.

Papish A, Kassam A, Modgill G, Vaz G, Zanussi L, Patten S . Reducing the stigma of mental illness in undergraduate medical education: a randomized controlled trial. BMC Med Educ. 2013; 13:141. PMC: 3828029. DOI: 10.1186/1472-6920-13-141. View

20.

Atzema C, Schull M, Tu J . The effect of a charted history of depression on emergency department triage and outcomes in patients with acute myocardial infarction. CMAJ. 2011; 183(6):663-9. PMC: 3071386. DOI: 10.1503/cmaj.100685. View