Grant: Doctoral Research Award: Canada Graduate Scholarships

People experiencing structural racism, sexism, homophobia, and intersections of these and other discriminatory systems have significantly higher prevalence of chronically poor mental health outcomes than those who do not face these barriers. While health care organizations have attempted to address these inequities by applying the concept of cultural competency in practice, this approach is limited to the level of the individual patient encounter. Structural competency represents a crucial evolution of cultural competency and is defined as the capacity for health care providers, organizations, and systems to recognize and respond to poor health outcomes as shaped by social, political, and economic structures. While structural competency is being integrated into health care education, it remains largely conceptual in practice and service delivery. Exploring structural competency in clinical settings offers enormous promise in actualizing health equity in clinical care, organizations, and health systems. Identifying processes to operationalize structural competency within mental health organizations is timely given the inequitable mental health consequences of the COVID-19 pandemic and the pressing need to address racism and mental health. This project seeks to answer the question of how to operationalize structural competency in mental health care delivery. This work has three objectives: 1) identify and summarize existing evidence in a scoping review on structural competency in mental health care; 2) to explore processes and practices that foster structural competency in mental health care; and 3) to analyze findings and develop strategic recommendations for integrating structural competency within mental health systems. This research will transform health care services and organizational frameworks by illuminating processes that address root causes of poor mental health outcomes among marginalized people, thus offering a path to achieving mental health equity.