Intersectional Social Identities, Discrimination and Mental Health Service Use in England

• In Event: 4124 - Section on Race, Gender, and Class Roundtables
  In Refereed Roundtable (100 min): Table 7. Mental Health and Wellness

Abstract

Grounded in stress process, social stratification and intersectionality theories, this study utilised national population-based data from England to examine mental health service use (MHSU) and treatment at the intersections of multiple advantaged and disadvantaged social statuses using Latent Class Analysis. Conceptualising discrimination as a causal process influencing discrepant mental health treatment and service use, it also examined whether discrimination has a differential influence across various intersecting social statuses after accounting for levels of underlying need. Each approach identified different disadvantaged population groups for whom, counter to expectations, MHSU/treatment was elevated relative to more advantaged groups after accounting for markers of need. Varying patterns of past year discrimination were also identified with the two approaches and, in contrast to the hypothesised direction of effect, discrimination predicted higher rather than lower levels of MHSU/treatment. Single status analyses revealed elevated discrimination in groups not represented by intersectional classes and in turn the intersectional class categories associated with greater discrimination were not indicated by single class analyses. There was little evidence for mediation by discrimination among intersectional classes. In contrast, single status analyses indicated that past-year discrimination acts as a stressor enhancing MHSU/treatment among people not identifying as heterosexual and, to a lesser degree among Black respondents. To improve understanding and inform action on social status-based inequalities, further research should incorporate multiple and mixed-methods approaches to identify and characterise complexities of social stratification processes, and to examine different dimensions of inequalities in mental health and care.

Authors

• Charlotte Woodhead

• Rebecca Rhead

• Zoe Chui, King's College London

• Luke Connor, King's College London

• Hannah Harwood, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK

• Shirlee MacCrimmon, King's College London

• Stephani Hatch, King's College, London