Behind the Stigma: A Narrative Inquiry into the Perception and Experiences of Mental Health, Addictions, and Forensic Nurses

Abstract

Mental health and forensic nurses work at the intersection of healthcare, law, and social justice, yet their roles remain undervalued within the nursing profession. This study explored how these nurses construct professional identity and resilience while navigating stigma and systemic inequity. A qualitative narrative inquiry design was used to gather written reflections from 14 nurses in Ontario and British Columbia, including registered nurses, registered practical nurses, and nurse practitioners. Participants responded to open-ended prompts through a secure online platform, describing experiences of stigma, workplace hostility, advocacy, and meaning in their work. Data were analyzed thematically and through a composite narrative approach to capture both individual and collective perspectives. Six major themes emerged: stigma and systemic misrepresentation, stigma toward patients, advocacy and emotional labor, workplace hostility, purpose and resilience, and systemic barriers. Findings demonstrate that nurses experience both external and internalized stigma that diminishes professional legitimacy, yet they construct identities grounded in empathy, advocacy, and relational expertise. The study applies Goffman’s concept of courtesy stigma and social identity theory to interpret how hierarchies shape belonging within healthcare. These results stress the need for stigma-reduction education, mentorship programs, and policy investment in community mental health services. Centering nurses’ voices through narrative inquiry reframes mental health and forensic nursing as advanced, relational, and justice-oriented practice.