{"id":86688,"date":"2025-06-16T11:52:00","date_gmt":"2025-06-16T15:52:00","guid":{"rendered":"https:\/\/mentalhealthcommission.ca\/?post_type=resource&#038;p=86688"},"modified":"2025-08-28T15:30:11","modified_gmt":"2025-08-28T19:30:11","slug":"structural-stigma-measures","status":"publish","type":"resource","link":"https:\/\/mentalhealthcommission.ca\/resource\/structural-stigma-measures\/","title":{"rendered":"Structural Stigma Measures"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"86688\" class=\"elementor elementor-86688\" data-elementor-post-type=\"resource\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3848dbe2 e-con-full e-flex e-con e-parent\" data-id=\"3848dbe2\" data-element_type=\"container\" data-e-type=\"container\" id=\"ss-header\">\n\t\t<div class=\"elementor-element elementor-element-778c64ca e-con-full ss-sidebar e-flex e-con e-child\" data-id=\"778c64ca\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-5f494b81 e-con-full ss-sidebar-container e-flex e-con e-child\" data-id=\"5f494b81\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-da9630b e-con-full ss-sidebar-arrow e-flex e-con e-child\" data-id=\"da9630b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4957038d elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"4957038d\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"side-bar-open\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<a class=\"elementor-icon\" href=\"#\">\n\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-caret-square-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M176 354.9V157.1c0-10.7 13-16.1 20.5-8.5l98.3 98.9c4.7 4.7 4.7 12.2 0 16.9l-98.3 98.9c-7.5 7.7-20.5 2.3-20.5-8.4zM448 80v352c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V80c0-26.5 21.5-48 48-48h352c26.5 0 48 21.5 48 48zm-48 346V86c0-3.3-2.7-6-6-6H54c-3.3 0-6 2.7-6 6v340c0 3.3 2.7 6 6 6h340c3.3 0 6-2.7 6-6z\"><\/path><\/svg>\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-45d7b4fd elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"45d7b4fd\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"side-bar-close\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<a class=\"elementor-icon\" href=\"#\">\n\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-caret-square-left\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M272 157.1v197.8c0 10.7-13 16.1-20.5 8.5l-98.3-98.9c-4.7-4.7-4.7-12.2 0-16.9l98.3-98.9c7.5-7.7 20.5-2.3 20.5 8.4zM448 80v352c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V80c0-26.5 21.5-48 48-48h352c26.5 0 48 21.5 48 48zm-48 346V86c0-3.3-2.7-6-6-6H54c-3.3 0-6 2.7-6 6v340c0 3.3 2.7 6 6 6h340c3.3 0 6-2.7 6-6z\"><\/path><\/svg>\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2f11fc56 e-con-full ss-sidebar-container-2 e-flex e-con e-child\" data-id=\"2f11fc56\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-53972b73 e-con-full e-flex e-con e-child\" data-id=\"53972b73\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-11f14ad1 elementor-widget elementor-widget-heading\" data-id=\"11f14ad1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#structural-stigma\">What is structural stigma?<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6fe8a409 elementor-widget elementor-widget-heading\" data-id=\"6fe8a409\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#quality-of-care-issue\">Stigma cultures are a <br \/> quality-of-care issue<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-691f546f elementor-widget elementor-widget-heading\" data-id=\"691f546f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#importance-of-measuring\">Importance of measuring <br \/>structural stigma<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3bfa8b73 elementor-widget elementor-widget-heading\" data-id=\"3bfa8b73\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#the-measurement-scales\">Measurement scales<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1c15a026 elementor-widget elementor-widget-heading\" data-id=\"1c15a026\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#spotlight-on-early-adopters\">Spotlight on early adopters<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f8a465d elementor-widget elementor-widget-heading\" data-id=\"1f8a465d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#faq\">Frequently asked <br \/>questions<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-114fcda2 elementor-widget elementor-widget-heading\" data-id=\"114fcda2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#contact-us\">Contact Us<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1c910716 elementor-widget elementor-widget-heading\" data-id=\"1c910716\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#demonstration-project\">Other Tips and Related Resources<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ca35c42 elementor-widget elementor-widget-heading\" data-id=\"3ca35c42\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<span class=\"elementor-heading-title elementor-size-default\"><a href=\"#other-tools\">Other measurement tools<\/a><\/span>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1a883ea4 elementor-position-inline-end elementor-view-default elementor-mobile-position-block-start elementor-widget elementor-widget-icon-box\" data-id=\"1a883ea4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<a href=\"#ss-header\" class=\"elementor-icon\" tabindex=\"-1\" aria-label=\"Back to top\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M34.9 289.5l-22.2-22.2c-9.4-9.4-9.4-24.6 0-33.9L207 39c9.4-9.4 24.6-9.4 33.9 0l194.3 194.3c9.4 9.4 9.4 24.6 0 33.9L413 289.4c-9.5 9.5-25 9.3-34.3-.4L264 168.6V456c0 13.3-10.7 24-24 24h-32c-13.3 0-24-10.7-24-24V168.6L69.2 289.1c-9.3 9.8-24.8 10-34.3.4z\"><\/path><\/svg>\t\t\t\t<\/a>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\t\t\t<div class=\"elementor-icon-box-content\">\n\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-box-title\">\n\t\t\t\t\t\t<a href=\"#ss-header\" >\n\t\t\t\t\t\t\tBack to top\t\t\t\t\t\t<\/a>\n\t\t\t\t\t<\/span>\n\t\t\t\t\n\t\t\t\t\n\t\t\t<\/div>\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2a54ee17 e-con-full e-flex e-con e-child\" data-id=\"2a54ee17\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4ff2242d elementor-widget elementor-widget-html\" data-id=\"4ff2242d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<!-- ss page hide and show -->\n<script 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class=\"elementor-button-text\">Fran\u00e7ais<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fe29be2 elementor-align-right elementor-widget elementor-widget-button\" data-id=\"fe29be2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-sink\" href=\"#contact-us\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Contact Us<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-55d48e30 elementor-align-right elementor-widget elementor-widget-button\" data-id=\"55d48e30\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-sink\" href=\"https:\/\/mentalhealthcommission.ca\/structural-stigma\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Structural Stigma<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-10385db elementor-widget elementor-widget-spacer\" data-id=\"10385db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3b7e56b8 e-con-full e-flex e-con e-child\" data-id=\"3b7e56b8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-154465b7 elementor-widget elementor-widget-spacer\" data-id=\"154465b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-503daf20 e-con-full e-flex e-con e-child\" data-id=\"503daf20\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-453821bf e-con-full e-flex e-con e-child\" data-id=\"453821bf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-48ef9b82 elementor-widget elementor-widget-heading\" data-id=\"48ef9b82\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Measuring Structural Stigma in Health Care <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e31cbf elementor-widget elementor-widget-text-editor\" data-id=\"1e31cbf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Addressing stigma in health care is crucial to ensure people with lived and living experience of mental health or substance use health concerns have access to quality care. Measuring and monitoring is a core principle of any quality improvement initiative. By measuring change, organizations can ensure that actions are effective in reducing the negative impacts of mental health and substance use (MHSU)-related structural stigma in health care. <\/p><p>\u00a0<\/p><p>Explore this page to<strong> learn more about the measurement scales<\/strong>, early adopter approaches using them, and related tips and resources to support a journey of commitment to a stigma-free health system.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-56e7119f e-con-full e-flex e-con e-child\" data-id=\"56e7119f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b04068f elementor-widget elementor-widget-button\" data-id=\"b04068f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-shrink\" href=\"#the-measurement-scales\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Scales<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-29970165 elementor-widget elementor-widget-button\" data-id=\"29970165\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-shrink\" href=\"#case-studies\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Case Studies<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6ba54b61 e-flex e-con-boxed e-con e-parent\" data-id=\"6ba54b61\" data-element_type=\"container\" data-e-type=\"container\" id=\"structural-stigma\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-2dc8c687 e-con-full e-flex e-con e-child\" data-id=\"2dc8c687\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6b71c688 elementor-widget elementor-widget-heading\" data-id=\"6b71c688\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"structural-stigma-two\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What is structural stigma?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-19485d72 e-con-full e-grid e-con e-child\" data-id=\"19485d72\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-126072e e-con-full e-flex e-con e-child\" data-id=\"126072e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f2ac9b7 elementor-widget elementor-widget-image\" data-id=\"f2ac9b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.youtube.com\/watch?v=6R9abpPsGyA\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"980\" height=\"491\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma-1024x513.jpg\" class=\"attachment-large size-large wp-image-95673\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma-1024x513.jpg 1024w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma-300x150.jpg 300w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma-768x385.jpg 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma-599x300.jpg 599w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/structural-stigma.jpg 1227w\" sizes=\"(max-width: 980px) 100vw, 980px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e686290 elementor-widget elementor-widget-heading\" data-id=\"e686290\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/www.youtube.com\/watch?v=6R9abpPsGyA\">Dismantle Mental Health and Substance Use-Related Structural Stigma in Health Care<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f84ff22 elementor-widget elementor-widget-text-editor\" data-id=\"f84ff22\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>In health care, structural stigma encompasses the organizational and societal rules, policies, procedures, laws, and cultural norms that increase stigma and raise barriers for people seeking to access the help they need. The result is unfair treatment of people with lived and living experience (PWLLE) of mental health and\/or substance use (MHSU) problems or illnesses. Such unfairness leads to inequitable access and lower quality of care for these individuals. It can also perpetuate de-prioritization, devaluation, and \u201cothering\u201d of mental health and substance use health, as compared with physical health, within our health-care delivery, governance, knowledge building, and training systems. <sup><a href=\"#references\">1<\/a><\/sup><\/p><p>Research has consistently identified the health-care system as a significant contributor to stigma for PWLLE.<\/p><p>Structural stigma also arises in cultures of care that exude negative and disempowering policies and practices. These \u201cstigma cultures\u201d undermine every aspect of recovery-oriented and person-centred care and act as an important barrier to system transformation. <sup><a href=\"#references\">2<\/a><\/sup><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-47c64e74 e-flex e-con-boxed e-con e-parent\" data-id=\"47c64e74\" data-element_type=\"container\" data-e-type=\"container\" id=\"quality-of-care-issue\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-58e90129 e-con-full e-flex e-con e-child\" data-id=\"58e90129\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-382b857 elementor-widget elementor-widget-heading\" data-id=\"382b857\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Stigma cultures are a quality-of-care issue<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-54fc8c4 e-con-full e-grid e-con e-child\" data-id=\"54fc8c4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4da0d66 elementor-widget elementor-widget-text-editor\" data-id=\"4da0d66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Stigma cultures in health-care settings are the organizational-level norms, values, assumptions, physical fa\u00e7ades, and practices that govern day to day activities and interactions. Aspects include poor quality of care, coercive care, a punitive and patronizing atmosphere, and disempowerment to make treatment decisions. <sup><a style=\"font-size: 10px;\" href=\"#references\">2<\/a><\/sup><\/p><p>Shaping cultures of care is increasingly viewed as an important means of improving safety and performance outcomes across the full spectrum of health-care settings and promoting high-quality, person-centred care. The management of cultures of care is increasingly considered to be a key aspect of health system reform, and interest in the concept of promoting more caring cultures has grown. <sup><a style=\"font-size: 10px;\" href=\"#references\">3<\/a><\/sup><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-66f19566 elementor-widget elementor-widget-image\" data-id=\"66f19566\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"800\" height=\"533\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1987096880.jpg\" class=\"attachment-large size-large wp-image-81470\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1987096880.jpg 800w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1987096880-300x200.jpg 300w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1987096880-768x512.jpg 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1987096880-450x300.jpg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-59f6eae7 e-flex e-con-boxed e-con e-parent\" data-id=\"59f6eae7\" data-element_type=\"container\" data-e-type=\"container\" id=\"importance-of-measuring\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-2c080187 e-con-full e-flex e-con e-child\" data-id=\"2c080187\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-66b0f73f e-con-full e-flex e-con e-child\" data-id=\"66b0f73f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-49621d40 e-con-full e-flex e-con e-child\" data-id=\"49621d40\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2e213cd5 elementor-widget elementor-widget-image\" data-id=\"2e213cd5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"534\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1496795538.jpg\" class=\"attachment-large size-large wp-image-81472\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1496795538.jpg 800w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1496795538-300x200.jpg 300w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1496795538-768x513.jpg 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1496795538-449x300.jpg 449w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-331e6015 e-con-full e-flex e-con e-child\" data-id=\"331e6015\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-e332d40 e-con-full e-flex e-con e-child\" data-id=\"e332d40\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-34a1ebd1 elementor-widget elementor-widget-heading\" data-id=\"34a1ebd1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Importance of measuring structural stigma<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e27e4a9 elementor-widget elementor-widget-text-editor\" data-id=\"e27e4a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>&#8220;It doesn\u2019t count until you count it.&#8221;<br \/><em>&#8211; Stephanie Knaak, Ph.D, Senior Research Consultant<br \/><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2edbd137 elementor-widget elementor-widget-spacer\" data-id=\"2edbd137\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-708f7b13 elementor-widget elementor-widget-text-editor\" data-id=\"708f7b13\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<strong>It is important to measure and address structural stigma for several reasons:<\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-27e17517 e-con-full e-grid e-con e-child\" data-id=\"27e17517\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-62a251dd e-con-full e-flex e-con e-child\" data-id=\"62a251dd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-52a353ae elementor-widget elementor-widget-text-editor\" data-id=\"52a353ae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>It is a groundbreaking way to approach health system reform.<\/strong> By measuring and addressing structural stigma, organizations can become champions in the quest to provide more equitable health care for PWLLE.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-69b7b25b e-con-full e-flex e-con e-child\" data-id=\"69b7b25b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3756c607 elementor-widget elementor-widget-text-editor\" data-id=\"3756c607\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Structural stigma affects not only patients and their families but also the providers who care for them.<\/strong> Addressing structural stigma can protect staff from experiencing moral distress. A workplace that protects workers from moral distress supports staff to do their job with a sense of integrity and in a manner consistent with their values. Learn more about how to support health-care workers at work <a style=\"font-size: 16px; color: #002c45;\" href=\"https:\/\/mentalhealthcommission.ca\/resource\/how-to-support-health-care-workers-at-work\/\">here<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5b8b9dd0 e-con-full e-flex e-con e-child\" data-id=\"5b8b9dd0\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4fb2583a elementor-widget elementor-widget-text-editor\" data-id=\"4fb2583a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<strong>Addressing structural stigma builds trust with patients and their families.<\/strong> Extensive research has shown that trust between patients and their providers plays an important role in producing better health outcomes. Trust in health-care institutions and health-care providers has been theorized and found to impact self-reported health, help-seeking, engagement with services, and treatment compliance. <sup><a style=\"font-size: 10px;\" href=\"#references\">4<\/a><\/sup>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6b3ed407 e-flex e-con-boxed e-con e-parent\" data-id=\"6b3ed407\" data-element_type=\"container\" data-e-type=\"container\" id=\"the-measurement-scales\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-293a360e e-con-full e-flex e-con e-child\" data-id=\"293a360e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6ee7dd66 elementor-widget elementor-widget-heading\" data-id=\"6ee7dd66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Measurement Scales<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-29459688 elementor-widget elementor-widget-text-editor\" data-id=\"29459688\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>An<strong> important first step to tackling structural stigma within health-care environments is to assess its scope and severity<\/strong>. To address this need, the Mental Health Commission of Canada (MHCC) developed the following tools to measure the scope and magnitude of stigma experienced by people with MHSU problems and illnesses:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1e937261 e-con-full e-grid e-con e-child\" data-id=\"1e937261\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-2b0f7b11 e-con-full e-flex e-con e-child\" data-id=\"2b0f7b11\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6468d747 elementor-widget elementor-widget-heading\" data-id=\"6468d747\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/mentalhealthcommission.ca\/resource\/stigma-cultures-in-health-care-scale\/\" target=\"_blank\">Stigma Cultures in Health Care Scale<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4245b1ef elementor-widget elementor-widget-heading\" data-id=\"4245b1ef\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/mentalhealthcommission.ca\/resource\/stigma-cultures-in-health-care-scale\/\" target=\"_blank\">(SCHCS)<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2add9d1f elementor-widget elementor-widget-text-editor\" data-id=\"2add9d1f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This scale was designed to capture stigma cultures in <strong>any health-care setting<\/strong> (including family doctors\u2019 offices, outpatient clinics, emergency departments, and hospitals) where people with a MHSU concern may seek care. It is a 23-item unidimensional scale.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5e326bb2 e-con-full e-flex e-con e-child\" data-id=\"5e326bb2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-52159330 elementor-widget elementor-widget-heading\" data-id=\"52159330\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/mentalhealthcommission.ca\/resource\/structural-stigma-in-mental-health-care-scale\/\" target=\"_blank\">Structural Stigma in Mental Health Care Scale<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-46f0654b elementor-widget elementor-widget-heading\" data-id=\"46f0654b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/mentalhealthcommission.ca\/resource\/structural-stigma-in-mental-health-care-scale\/\" target=\"_blank\"> (SSMHCS)<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-39bd4fa7 elementor-widget elementor-widget-text-editor\" data-id=\"39bd4fa7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This scale was designed to provide a cultural barometer of stigma experienced by individuals with a MHSU disorder receiving care in a <strong>MHSU service setting<\/strong>. It is a 20-item scale with two factors: an eight-item person-centred care factor and a 12-item coercive care factor.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-70e18e73 elementor-widget elementor-widget-text-editor\" data-id=\"70e18e73\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>The SCHCS and SSMHCS have been psychometrically tested using factor analytic procedures.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5b09120b elementor-widget elementor-widget-text-editor\" data-id=\"5b09120b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The scales are not meant to provide an objective measure of stigma. Rather, the scale scores provide a way to measure differences in experiences across different service user groups or health-care settings and\/or to measure change over time. For example, higher scale or item scores (reflecting higher levels of stigma) for patient groups receiving mental health care compared with physical health care may suggest the presence of discriminatory or inequitable treatment. <sup><a style=\"font-size: 10px;\" href=\"#references\">2<\/a><\/sup><\/p><p>The power of these tools is that they <strong>measure stigma from the perspective of service users themselves<\/strong>, thus providing a key quality assessment tool for any organization or setting interested in person-centred care.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-581c69c1 elementor-widget elementor-widget-text-editor\" data-id=\"581c69c1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The <strong>SCHCS<\/strong> or the <strong>SSMHCS<\/strong> can be the tool(s) that your organization needs to identify stigmatizing encounters reported by <strong>PWLLE<\/strong> as well to target areas in need of a change and\/or to assess and monitor the impact of organizational interventions to reduce structural stigma over time.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-158480c4 e-flex e-con-boxed e-con e-parent\" data-id=\"158480c4\" data-element_type=\"container\" data-e-type=\"container\" id=\"spotlight-on-early-adopters\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-4090786c e-con-full e-flex e-con e-child\" data-id=\"4090786c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-403975c elementor-widget elementor-widget-heading\" data-id=\"403975c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Spotlight on early adopters<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6fe87445 e-con-full e-grid e-con e-child\" data-id=\"6fe87445\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bc9247f elementor-widget elementor-widget-text-editor\" data-id=\"2bc9247f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Throughout 2023 and 2024, the MHCC worked with two health-care sites to field test the measurement scales. The goal of these pilot studies was to better understand how the scale(s) work in different real-world health-care settings, identify redundancies to potentially shorten the scale(s), and facilitate opportunities for quality improvement initiatives by supporting organizations in establishing baseline measurements from which to assess the effectiveness of their interventions.<\/p><p><strong>Learn about the approaches, results, and lessons learned through the two featured <a href=\"#\">case studies<\/a>.<\/strong><\/p><p>Please note that both pilot studies took place at large academic hospitals; it is important to be aware of the context of a research study when considering available resources, study design, recruitment, and other factors. Health-care settings can vary substantially, and there can be differences in the way health-care research and quality improvement are approached even among provincial and territorial jurisdictions. It is important to understand that different settings will have different contexts, and methods and approaches will need to be adapted for each particular setting.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5ab768e elementor-widget elementor-widget-image\" data-id=\"5ab768e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1492993735.jpg\" class=\"attachment-large size-large wp-image-81478\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1492993735.jpg 800w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1492993735-300x200.jpg 300w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1492993735-768x512.jpg 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1492993735-450x300.jpg 450w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7178d904 e-flex e-con-boxed e-con e-parent\" data-id=\"7178d904\" data-element_type=\"container\" data-e-type=\"container\" id=\"case-studies\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-41983b4e e-grid e-con-full e-con e-child\" data-id=\"41983b4e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-33e6d8f1 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"33e6d8f1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-sink\" href=\"https:\/\/mentalhealthcommission.ca\/resource\/structural-stigma-measures-case-study-ember-study\/\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Emergency Department Case Study<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-366824cb elementor-align-center elementor-widget elementor-widget-button\" data-id=\"366824cb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-sink\" href=\"https:\/\/mentalhealthcommission.ca\/resource\/structural-stigma-measures-case-study-consultation-liaison-service\/\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Consultation\/Liaison Service Case Study<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-36bbce8d e-flex e-con-boxed e-con e-parent\" data-id=\"36bbce8d\" data-element_type=\"container\" data-e-type=\"container\" id=\"faq\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-729d815e e-con-full e-flex e-con e-child\" data-id=\"729d815e\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;motion_fx_translateY_effect&quot;:&quot;yes&quot;,&quot;motion_fx_translateY_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:2,&quot;sizes&quot;:[]},&quot;motion_fx_translateY_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}},&quot;motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-61f38581 elementor-widget elementor-widget-heading\" data-id=\"61f38581\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Frequently asked questions (FAQs)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc0166f elementor-widget elementor-widget-heading\" data-id=\"cc0166f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Getting Started<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a2a3c6e ss-accordion elementor-widget elementor-widget-n-accordion\" data-id=\"3a2a3c6e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:500,&quot;sizes&quot;:[]},&quot;default_state&quot;:&quot;expanded&quot;,&quot;max_items_expended&quot;:&quot;one&quot;}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9750\" class=\"e-n-accordion-item\" open>\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"true\" aria-controls=\"e-n-accordion-item-9750\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Which scale should we select? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9750\" class=\"elementor-element elementor-element-11af12f4 e-flex e-con-boxed e-con e-child\" data-id=\"11af12f4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9750\" class=\"elementor-element elementor-element-5bc5ee88 e-con-full e-flex e-con e-child\" data-id=\"5bc5ee88\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5835c8cd elementor-widget elementor-widget-text-editor\" data-id=\"5835c8cd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> We recommend basing your selection on the type of health-care services your setting provides. SCHCS gathers more general information, while SSMHCS measures factors related to coercive care and patient-centred care, which are typically present in mental health and\/or substance use health-care settings.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9751\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9751\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Are the scales reliable measures? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9751\" class=\"elementor-element elementor-element-353be4f6 e-flex e-con-boxed e-con e-child\" data-id=\"353be4f6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9751\" class=\"elementor-element elementor-element-6e85243e e-con-full e-flex e-con e-child\" data-id=\"6e85243e\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7f47d184 elementor-widget elementor-widget-text-editor\" data-id=\"7f47d184\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Yes. The scales have undergone psychometric testing, and through pilot site demonstration they have proven to be reliable tools to measure stigma cultures. Though data are limited, we are confident that they are effective and broadly adaptable to any health-care context.<\/p><p>The research for the <a href=\"#\">SCHCS<\/a> has been published in the peer-reviewed scholarly journal <em>Social Psychiatry and Psychiatric Epidemiology<\/em>. Read the academic paper here: <em>Measuring aspects of stigma cultures in healthcare settings.<\/em> <a style=\"font-size: 14px !important;\" href=\"https:\/\/link.springer.com\/article\/10.1007\/s00127-024-02780-5#citeas\">https:\/\/link.springer.com\/article\/10.1007\/s00127-024-02780-5#citeas<\/a><\/p><p>The research for the SSMHCS has been published in the peer-reviewed scholarly journal <em>Public Library of Science (PLOS) \u2013 Mental Health<\/em>. Read the academic paper here: <em>Client experiences of structural stigma in mental healthcare settings <\/em>\u00a0<a href=\"https:\/\/doi.org\/10.1371\/journal.pmen.0000493\">https:\/\/doi.org\/10.1371\/journal.pmen.0000493<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9752\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9752\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Can we add qualitative questions in addition to the quantitative scale items? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9752\" class=\"elementor-element elementor-element-1a658105 e-flex e-con-boxed e-con e-child\" data-id=\"1a658105\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9752\" class=\"elementor-element elementor-element-6000e5d0 e-con-full e-flex e-con e-child\" data-id=\"6000e5d0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4ca0dc20 elementor-widget elementor-widget-text-editor\" data-id=\"4ca0dc20\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Yes. You can collect whatever information will be helpful to your research. Early adopters of the scales included options for qualitative feedback for answers that were particularly negative to gather additional details and context about the participants\u2019 experiences (i.e., if a participant answers a question with a negative versus positive response, there would be an open-field text option for them to provide additional comments).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9753\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9753\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Can my organization modify\/adapt the scale(s)? Should the scale(s) be used in their entirety or can items be left out? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9753\" class=\"elementor-element elementor-element-22abe4af e-flex e-con-boxed e-con e-child\" data-id=\"22abe4af\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9753\" class=\"elementor-element elementor-element-1aae977c e-con-full e-flex e-con e-child\" data-id=\"1aae977c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-15a125df elementor-widget elementor-widget-text-editor\" data-id=\"15a125df\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> We recommend using the scale in its entirety, but if there are items that will not resonate with your clientele, they can be removed. It is also possible to use a combination of the two scales. The case studies provide information on how the sites in the pilot studies approached adapting the scales into include within their own surveys.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9754\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9754\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What is an ideal sample size to establish a baseline measurement? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9754\" class=\"elementor-element elementor-element-5d36756f e-con-full e-flex e-con e-child\" data-id=\"5d36756f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9754\" class=\"elementor-element elementor-element-7cdf9cb7 e-flex e-con-boxed e-con e-child\" data-id=\"7cdf9cb7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-64e1fae8 elementor-widget elementor-widget-text-editor\" data-id=\"64e1fae8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> There is no one ideal sample size. The ideal sample size for your project will depend on your setting, population, project aims, and available resources.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9755\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"6\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9755\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> We know we need to include PWLLE in this work. Are there resources to support organizations in doing this in safe and meaningful ways? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9755\" class=\"elementor-element elementor-element-3c3934e4 e-flex e-con-boxed e-con e-child\" data-id=\"3c3934e4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9755\" class=\"elementor-element elementor-element-168a1425 e-con-full e-flex e-con e-child\" data-id=\"168a1425\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4a0f5874 elementor-widget elementor-widget-text-editor\" data-id=\"4a0f5874\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Yes. We recommend the IAP2 Framework. This has recently been adapted by the MHCC advisory councils to support meaningful\u00a0engagement of\u00a0PWLLE in\u00a0 <a href=\"http:\/\/mentalhealthcommission.ca\/resource\/engaging-with-people-with-lived-and-living-experience-of-mental-illness-effectively-the-mhccs-advisory-councils\/\" target=\"_blank\" rel=\"noopener\">Engaging with People with Lived and Living Experience of Mental Illness Effectively: The MHCC\u2019s Advisory Councils (PWLLE)<\/a><\/p><p>An additional resource: <a href=\"https:\/\/www.ccsa.ca\/sites\/default\/files\/2021-04\/CCSA-Partnering-with-People-Lived-Living-Experience-Substance-Use-Guide-en.pdf\"> Guidelines for Partnering with People with Lived and Living Experience of Substance Use and Their Families and Friends.<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9756\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"7\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9756\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Do ethics departments\/committees need to be involved? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9756\" class=\"elementor-element elementor-element-2fea1d7d e-flex e-con-boxed e-con e-child\" data-id=\"2fea1d7d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9756\" class=\"elementor-element elementor-element-4ceb2d6c e-con-full e-flex e-con e-child\" data-id=\"4ceb2d6c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-659bb290 elementor-widget elementor-widget-text-editor\" data-id=\"659bb290\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> This will depend on the setting. Be sure to check local policies.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-9757\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"8\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-9757\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> We don\u2019t have expertise in research design and methodology. How can we get started? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9757\" class=\"elementor-element elementor-element-56f7afb2 e-flex e-con-boxed e-con e-child\" data-id=\"56f7afb2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-9757\" class=\"elementor-element elementor-element-efeb225 e-con-full e-flex e-con e-child\" data-id=\"efeb225\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6eff1728 elementor-widget elementor-widget-text-editor\" data-id=\"6eff1728\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Depending on the setting, ethics approval might be required to conduct this type of research. To prepare for this, a comprehensive research protocol must be developed. This should outline all the details of the study (the research question, methodology for data collection, analysis, etc.).<\/p><p><a style=\"font-size: 12pt;\" href=\"https:\/\/www.who.int\/groups\/research-ethics-review-committee\/recommended-format-for-a-research-protocol\">The World Health Organization has an excellent resource outlining the necessary elements for research protocol (available in English only).<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-738e4944 e-con-full e-flex e-con e-child\" data-id=\"738e4944\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5a998a9e elementor-widget elementor-widget-heading\" data-id=\"5a998a9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Implementation &amp; Recruitment <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-74947351 ss-accordion elementor-widget elementor-widget-n-accordion\" data-id=\"74947351\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;expanded&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1950\" class=\"e-n-accordion-item\" open>\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"true\" aria-controls=\"e-n-accordion-item-1950\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What resources (staff, time, training, etc.) are needed to implement the scale(s)? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1950\" class=\"elementor-element elementor-element-71bbda24 e-con-full e-flex e-con e-child\" data-id=\"71bbda24\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1950\" class=\"elementor-element elementor-element-1694cbaf e-flex e-con-boxed e-con e-child\" data-id=\"1694cbaf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-64a34976 elementor-widget elementor-widget-text-editor\" data-id=\"64a34976\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> There is no one-size-fits-all approach. Be sure that all staff (or volunteers) understand the goal of conducting this research. Learn more about the recruitment approaches from the two case studies and apply the lessons learned to your own context.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1951\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1951\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> How can we adapt\/plan our recruitment and consent process to ensure accessibility while respecting patients with mental health and substance use health illnesses\/issues? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1951\" class=\"elementor-element elementor-element-53f5f496 e-flex e-con-boxed e-con e-child\" data-id=\"53f5f496\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1951\" class=\"elementor-element elementor-element-695b43e8 e-con-full e-flex e-con e-child\" data-id=\"695b43e8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bb76ce9 elementor-widget elementor-widget-text-editor\" data-id=\"2bb76ce9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Ensure PWLLE are centred in decision-making and project planning. This way, important considerations will have been discussed on ways to ensure respect, empathy, and accessibility are central components in your data collection methodology.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1952\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1952\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> How should patients be encouraged or engaged to participate? Are there risks to providing incentives? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1952\" class=\"elementor-element elementor-element-392ca4fc e-flex e-con-boxed e-con e-child\" data-id=\"392ca4fc\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1952\" class=\"elementor-element elementor-element-1f2450b2 e-con-full e-flex e-con e-child\" data-id=\"1f2450b2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b8dc1fe elementor-widget elementor-widget-text-editor\" data-id=\"b8dc1fe\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A<\/strong>: Incentives can be powerful motivators, but they do not come without risks. However, one of the health-care sites in the case studies found that offering incentives was a successful way to facilitate data collection in the emergency department. Other settings might not need incentives to support data collection (e.g., family practice or outpatient services).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1953\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1953\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What if patients cannot complete the survey (e.g. if they have cognitive impairment)? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1953\" class=\"elementor-element elementor-element-344b51df e-flex e-con-boxed e-con e-child\" data-id=\"344b51df\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1953\" class=\"elementor-element elementor-element-2b7368de e-con-full e-flex e-con e-child\" data-id=\"2b7368de\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6eb67c3a elementor-widget elementor-widget-text-editor\" data-id=\"6eb67c3a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A<\/strong>: Depending on your protocol, you could decide to engage a proxy to complete the survey on a patient\u2019s behalf, or you could simply not include individuals with impairments from the data collection. If you are in a setting where many patients experience cognitive impairment, consider this factor during planning.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1954\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1954\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> How can we effectively administer the scales to ensure diverse patient populations are represented? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1954\" class=\"elementor-element elementor-element-5f9e6ca6 e-flex e-con-boxed e-con e-child\" data-id=\"5f9e6ca6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1954\" class=\"elementor-element elementor-element-7a5274f0 e-con-full e-flex e-con e-child\" data-id=\"7a5274f0\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7666c886 elementor-widget elementor-widget-text-editor\" data-id=\"7666c886\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A<\/strong>: It is important to consider how your clientele, particularly marginalized individuals, can access the survey. Keep in mind that clients might be experiencing precarious housing, work, or social situations. To gather a more inclusive sample, be flexible and understanding and offer alternate methods for data collection.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1955\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"6\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1955\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> For how long should data be collected? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1955\" class=\"elementor-element elementor-element-42ac3b68 e-con-full e-flex e-con e-child\" data-id=\"42ac3b68\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1955\" class=\"elementor-element elementor-element-5f7f7bb4 e-flex e-con-boxed e-con e-child\" data-id=\"5f7f7bb4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-32d0f254 elementor-widget elementor-widget-text-editor\" data-id=\"32d0f254\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A<\/strong>: Each setting will have unique needs. A survey should be administered at least until the minimum sample size is achieved, which will vary from setting to setting. Do not attempt to collect baseline data for a long time as environmental factors will change over time, which might skew the results. Typically, a few months has been a reasonable time frame to achieve target sampling.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1956\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"7\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1956\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What kind of support can the MHCC offer to support implementation? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1956\" class=\"elementor-element elementor-element-103d6987 e-flex e-con-boxed e-con e-child\" data-id=\"103d6987\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1956\" class=\"elementor-element elementor-element-3318f113 e-con-full e-flex e-con e-child\" data-id=\"3318f113\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4bbc73dd elementor-widget elementor-widget-text-editor\" data-id=\"4bbc73dd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A<\/strong>: The MHCC has developed a comprehensive implementation guide that can support your efforts in producing transformative change. The structural stigma project staff is happy to answer questions to the best of their ability but cannot provide direct support for any quality improvement initiative.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7febeede e-con-full e-flex e-con e-child\" data-id=\"7febeede\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1bbfcb5a elementor-widget elementor-widget-heading\" data-id=\"1bbfcb5a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Evaluation &amp; Improvement<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-356a7ee6 ss-accordion elementor-widget elementor-widget-n-accordion\" data-id=\"356a7ee6\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;expanded&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-8960\" class=\"e-n-accordion-item\" open>\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"true\" aria-controls=\"e-n-accordion-item-8960\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Will the scale(s) identify what interventions should be made? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8960\" class=\"elementor-element elementor-element-58c24861 e-flex e-con-boxed e-con e-child\" data-id=\"58c24861\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8960\" class=\"elementor-element elementor-element-513e4f86 e-con-full e-flex e-con e-child\" data-id=\"513e4f86\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-716c921 elementor-widget elementor-widget-text-editor\" data-id=\"716c921\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> No. The scale(s) are designed to assess the presence and severity of stigma cultures. Each site will need to determine appropriate interventions to suit their unique needs.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-8961\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-8961\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What metrics will demonstrate progress in reducing structural stigma over time? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8961\" class=\"elementor-element elementor-element-96b58cb e-flex e-con-boxed e-con e-child\" data-id=\"96b58cb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8961\" class=\"elementor-element elementor-element-27190ebf e-con-full e-flex e-con e-child\" data-id=\"27190ebf\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3621bb1c elementor-widget elementor-widget-text-editor\" data-id=\"3621bb1c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Changes in scale scores over time will show your organization\u2019s progress (lower scores indicate less stigma). Measures of statistical significance will tell you if the change is real (and not due to chance), and effect-size calculations can provide a sense of the magnitude of change over time.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-8962\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-8962\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What actions should be taken first (after establishing a baseline)? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8962\" class=\"elementor-element elementor-element-7096de6f e-flex e-con-boxed e-con e-child\" data-id=\"7096de6f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8962\" class=\"elementor-element elementor-element-35aeaeca e-con-full e-flex e-con e-child\" data-id=\"35aeaeca\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2d83f7f elementor-widget elementor-widget-text-editor\" data-id=\"2d83f7f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Presenting the findings to your organization\u2019s quality improvement team, which should include patients and\/or family members, is a good first step. However, a project plan should be established before data collection begins.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-8963\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-8963\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> How long after implementing an intervention should a survey be re-administered? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8963\" class=\"elementor-element elementor-element-526b4ac1 e-flex e-con-boxed e-con e-child\" data-id=\"526b4ac1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8963\" class=\"elementor-element elementor-element-66f6a2b8 e-con-full e-flex e-con e-child\" data-id=\"66f6a2b8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-71dcc361 elementor-widget elementor-widget-text-editor\" data-id=\"71dcc361\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> This will differ from setting to setting, but we recommend waiting at least three to six months before engaging in a second round of data collection.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-8964\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-8964\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> What if the intervention is not successful and post-intervention data do not show a reduction in stigma culture? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-sort-down\" viewBox=\"0 0 320 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M41 288h238c21.4 0 32.1 25.9 17 41L177 448c-9.4 9.4-24.6 9.4-33.9 0L24 329c-15.1-15.1-4.4-41 17-41z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8964\" class=\"elementor-element elementor-element-365acfa6 e-flex e-con-boxed e-con e-child\" data-id=\"365acfa6\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-8964\" class=\"elementor-element elementor-element-7879668a e-con-full e-flex e-con e-child\" data-id=\"7879668a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3b43222f elementor-widget elementor-widget-text-editor\" data-id=\"3b43222f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>A:<\/strong> Not every intervention is successful. Don\u2019t become discouraged. Regroup with the project team and discuss the next steps. Forecasting possible challenges is a critical part of any project planning. It is unlikely that after appropriate interventions stigma cultures would worsen. Consider other factors that might be affecting the results.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4ca40823 e-flex e-con-boxed e-con e-parent\" data-id=\"4ca40823\" data-element_type=\"container\" data-e-type=\"container\" id=\"contact-us\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-716f4bd1 e-con-full e-flex e-con e-child\" data-id=\"716f4bd1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5aa05630 elementor-widget elementor-widget-heading\" data-id=\"5aa05630\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Contact Us<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6c6f8fe7 e-con-full e-flex e-con e-child\" data-id=\"6c6f8fe7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1b0f3c82 elementor-widget elementor-widget-text-editor\" data-id=\"1b0f3c82\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tDo you have additional questions or want to learn more about structural stigma and MHCC\u2019s current work? Please reach out to <a style=\"color: #b3da83; font-size: 18px;\" href=\"mailto:mhccinfo@mentalhealthcommission.ca\">mhccinfo@mentalhealthcommission.ca<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1fd88251 e-flex e-con-boxed e-con e-parent\" data-id=\"1fd88251\" data-element_type=\"container\" data-e-type=\"container\" id=\"demonstration-project\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-4b115335 e-con-full e-flex e-con e-child\" data-id=\"4b115335\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3778df8f elementor-widget elementor-widget-heading\" data-id=\"3778df8f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Other tips and related resources<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3cfe6085 elementor-widget elementor-widget-spacer\" data-id=\"3cfe6085\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6cb755b7 e-con-full e-flex e-con e-child\" data-id=\"6cb755b7\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-11fd01af e-con-full e-flex e-con e-child\" data-id=\"11fd01af\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3772d859 elementor-widget elementor-widget-text-editor\" data-id=\"3772d859\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4 style=\"font-size: 15pt;\"><strong>Use available resources to increase awareness:<\/strong><\/h4><ul><li>The need to reduce stigma is often top of mind, but many don\u2019t know how or where to start achieving this. We recommend using <a href=\"https:\/\/mentalhealthcommission.ca\/structural-stigma\/dismantling-structural-stigma-in-health-care-implementation-guide\/\"><strong><em>Dismantling structural stigma in health care: An implementation guide to making real change for and with people with lived and living experiences of mental health problems or illnesses and\/or substance use concerns<\/em><\/strong><\/a> to support this work<strong>. <\/strong>The guide shares knowledge about the key features of structural change and strategies and the considerations for making it happen \u2014 and provides guidance to those interested in reducing MHSU-related structural stigma in their organizations.<\/li><li>Free online training is available to help you learn more about the impacts of structural stigma in health care and how to dismantle it (created in partnership with CHA Learning). <a href=\"https:\/\/chalearning.ca\/programs-and-courses\/structural-stigma-training-for-health-care-leaders\/\">Mental Health Structural Stigma in Health Care Course | CHA Learning<\/a><\/li><\/ul><h4 style=\"font-size: 15pt;\"><strong>Consider your organization\u2019s readiness:<\/strong><\/h4><ul><li>Any intervention to address MHSU-related structural stigma first requires an understanding of what is needed: organizational readiness to disrupt existing norms, a clear vision for change, and acceptance of the discomfort that comes from thinking about and doing things differently. Completing a readiness assessment could help your organization to better understand how implementing the SCHCS or SSMHCS fits into your site\u2019s current work and context. <a href=\"https:\/\/implementation.fpg.unc.edu\/resource\/the-hexagon-an-exploration-tool\/\">The Hexagon tool<\/a> <sup><a style=\"font-size: 10px;\" href=\"#references\">5<\/a><\/sup> can assess fit and feasibility at any implementation stage.<\/li><\/ul><h4 style=\"font-size: 15pt;\"><strong>Be realistic:<\/strong><\/h4><ul><li>Transformative change takes time, and this is just the first step. You will be looking at your organization more critically and challenging existing practices and policies that may be perpetuating structural stigma. Expect pushback: remain persistent and plan for resistance.<\/li><\/ul><h4 style=\"font-size: 15pt;\"><strong>Learn from others:<\/strong><\/h4><ul><li>The \u201c<strong>spotlight on early adopters<\/strong>\u201d case studies provide valuable insight into the process of implementing the structural stigma measurement scales. Review the methods, approaches, and lessons learned to help support the development of your implementation plan.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-52b2c6fd e-con-full e-flex e-con e-child\" data-id=\"52b2c6fd\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-239a2d04 elementor-widget elementor-widget-image\" data-id=\"239a2d04\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"683\" height=\"1024\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1183615699-683x1024.jpg\" class=\"attachment-large size-large wp-image-81480\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1183615699-683x1024.jpg 683w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1183615699-200x300.jpg 200w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1183615699-768x1152.jpg 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/1183615699.jpg 1000w\" sizes=\"(max-width: 683px) 100vw, 683px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6ee5652c e-flex e-con-boxed e-con e-parent\" data-id=\"6ee5652c\" data-element_type=\"container\" data-e-type=\"container\" id=\"other-tools\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-10347221 e-con-full e-flex e-con e-child\" data-id=\"10347221\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-10cfbd94 elementor-widget elementor-widget-heading\" data-id=\"10cfbd94\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Other measurement tools<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6249ff01 elementor-widget elementor-widget-text-editor\" data-id=\"6249ff01\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The Mental Health Commission of Canada has been championing anti-stigma initiatives since its inception. Here are some other stigma measurement tools and resources the MHCC has developed in collaboration with <a href=\"https:\/\/openingminds.org\/about\/\">Opening Minds.<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-18b917e3 e-flex e-con-boxed e-con e-parent\" data-id=\"18b917e3\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-18f86460 e-con-full e-flex e-con e-child\" data-id=\"18f86460\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-11d61773 e-con-full e-flex e-con e-child\" data-id=\"11d61773\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-667c9e80 elementor-widget elementor-widget-text-editor\" data-id=\"667c9e80\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tThe<strong> Opening Minds Stigma Scale for Health Care Providers<\/strong> (<strong>OMS-HC<\/strong>) was developed to measure stigma in health-care provider populations.\n\nTo learn more, access the <a style=\"font-size: 18px; color: #dfefcb;\" href=\"https:\/\/bmcpsychiatry.biomedcentral.com\/articles\/10.1186\/1471-244X-14-120\">Opening Minds Stigma Scale for Health Care Providers (OMS-HC): Examination of psychometric properties and responsiveness<\/a>. <sup><a style=\"font-size: 10px; color: #fff;\" href=\"#references\">6<\/a><\/sup>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5f948247 e-con-full e-flex e-con e-child\" data-id=\"5f948247\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;gradient&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7f1f9592 elementor-widget elementor-widget-text-editor\" data-id=\"7f1f9592\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The <a style=\"color: #dfefcb; font-size: 18px;\" href=\"https:\/\/mentalhealthcommission.ca\/resource\/opening-minds-provider-attitudes-towards-opioid-use-scale-om-patos\/\"><strong>Opening Minds Provider Attitudes Toward Opioid Use Scale (OM-PATOS)<\/strong><\/a> was designed to help professionals who respond to or care for people who are experiencing opioid use problems or are at risk of an overdose or poisoning, such as paramedics, fire or police services workers, health-care and social-care providers, pharmacists and counsellors.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61f0bf6e elementor-widget elementor-widget-text-editor\" data-id=\"61f0bf6e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<strong>To learn more, access the research article.\n<\/strong><a style=\"color: #dfefcb; font-size: 16px;\" href=\"https:\/\/link.springer.com\/article\/10.1007\/s11469-022-00788-z#citeas\">Measuring Stigma Towards People with Opioid Use Problems: Exploratory and Confirmatory Factor Analysis of the Opening Minds Provider Attitudes Towards Opioid-Use Scale (OM-PATOS)<\/a>. <sup><a style=\"font-size: 10px; color: #fff;\" href=\"#references\">7<\/a><\/sup>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2c64f085 e-grid e-con-boxed e-con e-parent\" data-id=\"2c64f085\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-67070951 e-con-full e-flex e-con e-child\" data-id=\"67070951\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-3b892d27 e-con-full e-flex e-con e-child\" data-id=\"3b892d27\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-abb6876 elementor-widget elementor-widget-heading\" data-id=\"abb6876\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Measuring Stigma Related to Opioid Use<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71ce6057 elementor-widget elementor-widget-text-editor\" data-id=\"71ce6057\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Discover how to use the scale to evaluate and assess the impact of stigma reduction initiatives and hear about the<\/strong> MHCC\u2019s work to assess opioid stigma reduction programs in the webinar <strong>Measuring Stigma Related to Opioid Use.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b89933a e-con-full e-flex e-con e-child\" data-id=\"b89933a\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c96ddb6 elementor-widget elementor-widget-image\" data-id=\"c96ddb6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/www.youtube.com\/watch?v=8KfUgqoiczs\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"980\" height=\"470\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar-1024x491.png\" class=\"attachment-large size-large wp-image-95719\" alt=\"\" srcset=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar-1024x491.png 1024w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar-300x144.png 300w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar-768x368.png 768w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar-626x300.png 626w, https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/stigma-webinar.png 1318w\" sizes=\"(max-width: 980px) 100vw, 980px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c720a40 elementor-widget elementor-widget-heading\" data-id=\"c720a40\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><a href=\"https:\/\/www.youtube.com\/watch?v=8KfUgqoiczs\" target=\"_blank\">Measuring Stigma Related to Opioid Use<\/a><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-64c53495 e-flex e-con-boxed e-con e-parent\" data-id=\"64c53495\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-202818a0 elementor-widget elementor-widget-spacer\" data-id=\"202818a0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-710574d7 elementor-hidden-tablet elementor-hidden-mobile e-flex e-con-boxed e-con e-parent\" data-id=\"710574d7\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-5417e30b e-con-full e-flex e-con e-child\" data-id=\"5417e30b\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-48d1a84e elementor-widget elementor-widget-heading\" data-id=\"48d1a84e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">References<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-520c1b04 elementor-widget elementor-widget-text-editor\" data-id=\"520c1b04\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"references\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><sup>1<\/sup> <em><strong>Grimminck, R., Knaak, S., Szeto, A., &amp; Clair, V. (2023).<\/strong><\/em> The urgent need to address mental health and substance use structural stigma in BC. BC Medical Journal, 65(6), 225\u2013226.<\/p><p><sup>2<\/sup> <em><strong>Stuart, H., &amp; Knaak, S. (2024).<\/strong><\/em> Measuring aspects of stigma cultures in healthcare settings. Social Psychiatry and Epidemiology. https:\/\/doi.org\/10.1007\/s00127-024-02780-5<\/p><p><sup>3<\/sup> <em><strong>Gillin, N., Taylor, R., &amp; Walker, S. (2017).<\/strong><\/em> Exploring the concept of caring cultures: A critical examination of the conceptual, methodological and validity issues with the caring cultures construct. Journal of Clinical Nursing, 26(23\u201324), 5216\u20135223.<\/p><p><sup>4<\/sup> <em><strong>Xavier, S. M., Malla, A., Mohan, G., et al. (2023).<\/strong><\/em> Trust of patients and families in mental healthcare providers and institutions: A cross-cultural study in Chennai, India and Montreal, Canada. Preprint. Research Square, rs.3.rs-2584056. doi:10.21203\/rs.3.rs-2584056\/v1<\/p><p><sup>5<\/sup> <em><strong>Metz, A. &amp; Louison, L.<\/strong> <\/em>(2018) The Hexagon Tool: Exploring Context. Chapel Hill, NC: National Implementation Research Network, Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill. Based on Kiser, Zabel, Zachik, &amp; Smith (2007) and Blase, Kiser &amp; Van Dyke (2013)<\/p><p><sup>6<\/sup> <em><strong>Modgill, G., Patten, S. B., Knaak, S., Kassam, A., &amp; Szeto, A.C. H. (2014)<\/strong><\/em>. Opening Minds Stigma Scale for Health Care Providers (OMS-HC): Examination of psychometric properties and responsiveness. BMC Psychiatry, 14(120). https:\/\/doi.org\/10.1186\/1471-244X-14-120<\/p><p><sup>7<\/sup> <em><strong>Knaak, S., Patten, S., &amp; Stuart, H. (2022).<\/strong><\/em> Measuring stigma towards people with opioid use problems: Exploratory and confirmatory factor analysis of the Opening Minds Provider Attitudes Towards Opioid-Use Scale (OM-PATOS). International Journal of Mental Health and Addiction, 20, 3398-3409. https:\/\/doi.org\/10.1007\/s11469-022-00788-z<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-55ab5417 e-flex e-con-boxed e-con e-parent\" data-id=\"55ab5417\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-21bd04ae e-con-full e-grid e-con e-child\" data-id=\"21bd04ae\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4e94385a elementor-widget elementor-widget-image\" data-id=\"4e94385a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/dev-mhcc.pantheonsite.io\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"226\" height=\"86\" src=\"https:\/\/mentalhealthcommission.ca\/wp-content\/uploads\/2025\/05\/white-logo-1.png\" class=\"attachment-large size-large wp-image-81502\" alt=\"\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-41340279 e-con-full e-flex e-con e-child\" data-id=\"41340279\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-babc4e7 elementor-widget elementor-widget-html\" data-id=\"babc4e7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<!-- ss page hide and show -->\n<script type=\"text\/javascript\">\njQuery(document).ready(function(){\n  jQuery(\".ss-sidebarmenu\").hide;\n});\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6b72494c elementor-widget elementor-widget-text-editor\" data-id=\"6b72494c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>\u00a9 2025 Mental Health Commission of Canada<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>What is structural stigma? Stigma cultures are a quality-of-care issue Importance of measuring structural stigma Measurement scales Spotlight on early adopters Frequently asked questions Contact Us Other Tips and Related Resources Other measurement tools Back to top<\/p>\n","protected":false},"author":157,"featured_media":87326,"parent":0,"template":"elementor_canvas","meta":{"_acf_changed":false,"footnotes":""},"categories":[809],"tags":[],"program":[],"program-area":[261],"audience":[],"covid-hub-category":[],"health-canada":[835,834,838],"class_list":["post-86688","resource","type-resource","status-publish","has-post-thumbnail","hentry","category-professional-resources","program-area-structural-stigma","health-canada-frontline","health-canada-professionals","health-canada-stigma"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.3 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Structural Stigma Measures - Mental Health Commission of Canada<\/title>\n<meta name=\"description\" content=\"What is structural stigma? 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