The human side of structural stigma: a call to action to address the lack of equity in mental health and substance use care
Bibliographic record
Abstract
Structural mental health and substance use (MHSU) stigma is a health equity and human rights issue that results in significant disparities in health outcomes for people with MHSU disorders. Two early career psychiatric physicians share the vicarious and witnessed experiences of their patients within the public mental health system, especially those deemed to be high risk. The authors also describe barriers patients face, and the unacceptable reality that mental health emergencies are systematically not handled as such, to the detriment of patient, family and provider well-being. Strategies to address structural MHSU stigma are also discussed with a particular emphasis on the emergency psychiatry context.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.032 | 0.048 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.017 | 0.047 |
| Scholarly communication | 0.020 | 0.030 |
| Open science | 0.004 | 0.021 |
| Research integrity | 0.046 | 0.055 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".