Evidence map›Paper›PMID 41662092›Full record

ArticlePLOS mental health2025

Client experiences of structural stigma in mental healthcare settings.

Heather Stuart, Stephanie Knaak

Abstract read
In one paragraph

Article in PLOS mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Heather StuartDepartment of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.ORCID https://orcid.org/0000-0002-8098-6652
Stephanie KnaakMental Health Commission of Canada, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0001-7663-3451

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Structural stigma in mental healthcare is reflected in organizational cultures of care that are experienced by service recipients as negative and disempowering. This includes pathways to care, clinical practices, shared ways of thinking, patterns of communications, and patterns of interaction. We report on (a) the prevalence of structural stigma experienced by a national sample of 818 clients 18 years of age or older receiving mental or substance use care in the past two years, and (b) the testing of two new scales to assess structural stigma in mental healthcare settings; The Coercive Care Scale and the Person-centred Scale. Structural stigma experiences were drawn from a prior focus group study. Survey respondents for psychometric testing were sampled from a large Canadian polling firm using a national sample. Exploratory and confirmatory factor analyses were performed on random split halves of the sample. Respondents reported a wide range of experiences indicative of structural stigma. Over half reported a punitive or coercive care experience and almost half reported care that was not person-centred. Factor analyses resulted in two sub-scales: one measuring 12 aspects of coercive care (The Coercive Care Scale, alpha = .92) and the other measuring 8 aspects of person-centred care (The Person-centred Scale, alpha = .86), both with excellent reliability. These scales are unique in that they are grounded in the personal experiences of service users and characterize an entire episode of care (rather than a specific provider/client interaction) from the perspective of the individual receiving care. Items can be used to target specific issues for quality improvement initiatives or aggregated into their sub-scales to monitor cultural change over time. Tools such as these can foster efforts to identify and reduce structural stigma in mental healthcare settings and assess the effectiveness of anti-stigma interventions designed to improve stigma cultures.

Identifiers

PMID41662092
PMCPMC12798476

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.