An Exploration of Mental Health-Related Stigma in an Emergency Setting

Mental health-related concerns are ubiquitous and deserving of the same compassion and support offered for other health problems. However, the scarcity of resources for mental health (MH) issues remains a complex public health problem. EMBER researchers sought to identify gaps in understanding of MH-related stigma in emergency departments (EDs) through interviews with (1) ED physicians/residents, nurses; (2) ED psychiatric physicians/residents, nurses; (3) protective services staff; and (4) patients and family members/support persons. Nine focus groups and 26 interviews were conducted with a total of 46 participants. Interviews/focus groups were coded using thematic analysis through research team discussion. Findings demonstrated structural stigma is a major barrier to accessing quality healthcare services and a key driver of interpersonal and intrapersonal stigma. Sustained, integrated interventions are needed to address key inequities, particularly in the model of care and service delivery, the culture of caring, in staff training, and in the ED physical space. Building trauma and resiliency-informed models of care was identified as an important foundational step in this process.