Welcome: Stigma-Free Organisations
Understanding Stigma: What It Is and Why It Matters
Evidence‑Based Ways to Reduce Stigma (Overview)
Social Contact: The “Why” and the “How”
Education: Building Understanding Without Oversimplifying
Training: Turning Values Into Behaviour and Practice
Structural Interventions: Changing the game, not just the players
Multicomponent Approaches: Combining Actions for Greater Impact
The Implementation Pathway: Co‑Producing and Delivering Change
Avoiding Unintended Harms and Embedding Change
Wrapping up

Structural Interventions: Changing the game, not just the players

Structural stigma is created when organisational policies, procedures, norms and rules restrict people’s rights and opportunities. Because these structures shape staff behaviour and service access, changing them can create wider, more sustainable improvements than focusing on attitudes alone.

What structural interventions are

Structural interventions change the conditions that produce stigma. They might address:

Service Access

Removing exclusionary eligibility criteria (e.g. abstinence‑only thresholds)

Reducing waiting times and bureaucracy that delays support

Removing policies that unintentionally block access for people with co-existing needs

Operations

Changing how, where, when and with whom services are delivered

Improving complaints and feedback processes

Strengthening partnerships and pathways across services to prevent people being bounced between services

Power

Embedding lived experience in decision‑making

Valuing lived experience in your workforce

Creating roles for people with living experience in governance, workforce and service design

Ensuring shared authority/power rather than advisory‑only involvement

Financing and resources

Investing in training, staffing, infrastructure, and quality improvement

Shifting incentives and targets to support outcomes valued the most by people who use services

Recognising that resources often enable all other structural change

What makes structural change more likely to succeed?

Structural interventions are disruptive — they change routines — so success is helped by:

Leadership buy‑in and sometimes influential stakeholder (funder/government) support

Organisational readiness – is there a no-blame culture that allows a shared recognition that some routines may be discriminatory?

Shared governance through co‑production and inclusive roles

Organisational value/purpose alignment - does the organisations guiding principles reference equity, inclusion and trauma‑informed approaches?

Structural work also needs relational trust because people may be cautious if they’ve experienced stigma repeatedly and doubt change is real. Listening, transparency and ongoing feedback help rebuild confidence.

A practical starting point

If you’re unsure where to start:

Identify one policy or procedure that frequently creates exclusion or conflict – this may be something the organisation has previously rationalised but would like to focus on afresh.

Map who has the authority to change it.

Co‑produce alternative approaches with people affected by it.

Trial a change, monitor impact, and go back to point 3 if needed and repeat