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Disrupting Stigma for Better Care

The UNITE Project is a journey into understanding each other’s experiences of stigma to celebrate diversity and create change. Through UNITE, we aim to come together to disrupt social and structural stigma in mental health and substance use care.

About the UNITE project

UNITE is a multi-year (2020-23) initiative to address and combat stigma faced by people living with mental health and substance use challenges. It involves a number of initiatives, including a video series, facilitated dialogues with staff, clients and families, community events to promote understanding, and journey mapping with clients to help foster an ongoing culture of excellence in patient experience.

Why addressing stigma is a priority

People with lived and living experience of concurrent mental health and substance use, and criminal justice involvement, are often misunderstood and heavily stigmatized. Stigma and discrimination push people into the shadows and isolate already underserved and marginalized groups.

Unfortunately, stigma and discrimination in healthcare often result in barriers to people accessing services, poorer quality of care, and poorer health outcomes. Stigma around mental health or substance use can make people feel they don't deserve care, or can cause people to feel uncomfortable being open with a care provider about the level of help they need.

We recognize that an intersectional approach is necessary to address stigma. People navigate the health system with multiple identities. For example, a healthcare worker may also experience mental health and substance use challenges, a client may also have a family member who is struggling, and an Indigenous person will experience incarceration differently than a non-Indigenous person. Through UNITE, we aim to create a safe environment for all people delivering, receiving, and impacted by healthcare.

"Stories of Stigma" video series

People with lived and living experience are experts in their own care. At BC Mental Health and Substance Use Services, we work with patient partners to ensure everything from policies to programming is inclusive of client perspectives.

"Stories of Stigma" is a three-part video series co-created with patient partners featuring the stories and voices of three people with mental health and substance use disorders. Through these personal stories of how stigma impacted each person's healthcare experience and outcomes, we can learn, understand and improve the care we provide.





Dialogue Companion

The “Stories of Stigma” Dialogue Companion (PDF) for the UNITE video series was created to stimulate individual and group reflection after viewing each video. Dialogue calls us to explore questions together and build relationships, rather than share information and solve problems. Through dialogue, we have the power to foster an environment where stigma and shame does not have the chance to grow, where diversity is celebrated, and where change unfolds.

See how the Dialogue Companion (PDF) can help you to facilitate people coming together in a spirit of openness and curiosity.

Family partner video series

This three-part animated video series will bring you along a journey into the stories of family members of people with lived and living experience of mental health complexities, substance use issues and criminalization. It explores the roles that families play and how stigma has impacted them, how they have navigated trust and identity, and their insights and hopes for the health care system.

Three family members were brought together by BC Mental Health and Substance Use Services to share their narratives and wisdom as caregivers and loved ones. Through open-dialogue discussions, guided by words of hope and encouragement from peers of similar experience, the storytellers were asked questions about stigma or discriminations experienced as families assisting their loved one to navigate complex systems, as well as questions about their personal healing journey.




Resources for understanding and facilitating dialogue

People often find it difficult to see eye-to-eye on social issues as complex and contested as mental health, substance use, and crime. Our inability to see that we are fundamentally connected can lead to stigma.

Dialogue brings people together and bridges divides within communities by exploring diversity and different perspectives. Through dialogue, we have the opportunity to play a transformational role in combatting stigma by getting to know people beyond a diagnosis or label.

In partnership with the Canadian Institute for Substance Use Research, we have co-created a suite of dialogue resources that can be used to address almost any challenge in any setting. We invite you to use them in your own communities.

Resources for co-design

The UNITE initiative is co-designed with people with lived and living experience. Co-design is a process that involves the people most impacted by the initiative as shared decision-makers. People with lived and living experience act as co-designers along with staff, leaders, and video animators to build the planning, delivery, and evaluation of UNITE.

There is no single approach or one-size-fits-all method for co-design. To learn more about the co-design process, visit the resources below.

Patient and client journey mapping

Journey mapping is the real-time translation of patient and client stories into a visual map with text. It depicts the journey through care from the patient perspective, ideally from pre-intake through to post-discharge.

By listening to patients' experiences and organizing them into a graphical illustration, our hope is to better understand how patients of BC Mental Health and Substance Use Services interact with our programs by exposing pain points and opportunities for improvement across the service continuum.

To understand and address stigma faced by our patients and clients, we facilitated journey mapping with a representative group of patients at Heartwood Centre for Women, Forensic Psychiatric Hospital, Forensic Psychiatric Clinics, and Correctional Health Services. Through this process, we gained a deeper understanding of what end-to-end care within our services look like from the patient point of view. It helped shine a light on specific areas where we can focus on quality improvement, including:

  • Enhanced communication at intake and discharge
  • Skills-building and self-care workshops for clients moving from inpatient to outpatient care environments
  • Opportunities for more collaborative family partnerships

Patient and client journey mapping gives the people we serve a powerful voice and has a lasting impact on the way we deliver care.

SOURCE: Disrupting Stigma for Better Care ( )
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