An inquiry into stigma within mental health care policy

Stigma is a major obstacle in the lives of people living with mental illness. This research uses a critical discourse analysis to examine instances of stigma embedded within mental health care policies in one Canadian mental health and addictions program. Drawing on the work of Foucault, Bourdieu and Goffman, this study focuses on the social power, domination and inequality that exist and become perpetuated within the social and institutional hospital environment. This example is used to explicate themes that are relevant for considerations of stigma in mental health care more generally. Three themes that emerged from the policy analysis are: paternalism, deviance and social exclusion. Overall recommendations for policy development are: 1) avoid over-generalization, 2) involve people with lived experience, 3) explicitly examine draft policies for the presence of potentially stigmatizing language and policy directives, and 4) emphasize the importance of the therapeutic bond when evaluating policy for stigma.