Stigma Cultures in Health Care Scale (SCHCS)
The Stigma Cultures in Health Care Scale (SCHCS) study was completed in collaboration with the Mental Health Commission of Canada, whose support made this research possible and contributed to advancing understanding of stigma within healthcare settings.
Our Study
- Structural stigma in healthcare refers to organizational norms, policies, and practices that shape patient experiences
- It can negatively impact care, especially for individuals with mental health concerns
- The study aimed to:
- Measure structural stigma in an emergency department (ED)
- Evaluate whether system-level changes reduce stigma
- Mixed-methods design combining quantitative surveys and qualitative responses
- Sample included patients visiting the ED for:
- Physical health (PH)
- Mental health (MH)
- Both PH & MH
- Scales:
- Stigma Cultures in Health Care Scale (SCHCS)
- 23 items
- Structural Stigma in Mental Health Care Scale (SSMHCS)
- 7 items from coercive care subscale
- 1 item from the person-centered care subscale
- Stigma Cultures in Health Care Scale (SCHCS)
- Data collection (May 2023-April 2026)
- 710 surveys completed
Manuscript in preparation.
Related Literature
Stuart, H., & Knaak, S. (2022). Psychometric analysis of a new measure to assess structural stigma in healthcare settings: Confirmatory factor analysis results. Mental Health Commission of Canada.
Measuring aspects of stigma cultures in healthcare settings
Healthcare culture plays an important role in shaping patient experiences. This study developed and validated the Stigma Cultures in Healthcare Scale, a tool designed to measure how people with mental health and substance use concerns experience stigma within healthcare settings.
Based on the lived experiences of healthcare users across Canada, the scale assesses factors such as person-centred care, involvement in decision-making, communication, respect, and support. The findings highlight the ongoing impact of structural stigma in healthcare and provide organizations with a practical tool to identify areas for improvement and advance more equitable, recovery-oriented care.
Client experiences of structural stigma in mental healthcare settings
Structural stigma can be embedded within the cultures, policies, and practices of mental healthcare settings. This study explored service users’ experiences of stigma and developed two new tools: the Coercive Care Scale and the Person-Centred Care Scale.
The measures assess experiences such as autonomy, choice, support, communication, and respect, helping to identify how healthcare environments can either contribute to or reduce structural stigma. These validated tools support efforts to improve mental healthcare systems and promote more compassionate, recovery-oriented, trauma-informed, and person-centred care.
