Intersectionality and disparities in mental health

1. Intersectionality and disparities in mental health • Intersectionality is a way of thinking about how the multiple social identities (like gender, race, class, religion, etc.) and their accompanying oppressions work together or ‘intersect’ with each other simultaneously in people’s experiences • Limited research of intersectionality on mental health, even less so on black and minority ethnic (BME) communities • Stigma, faith and mental health • Spirituality and faith were seen as key factors to understand mental illness and to help those with mental illness keep well • However the situation is complicated in determining how the different factors intersect and impact on experiences or outcomes for BME people and mental health. Eg. A study by NHS Digital found Muslims accessing IAPT services had a lower rate of recovery than those of other faiths but this is not clear what intersecting factors made the difference.

2. Gender, race and migration • Chinese women at greater risk of poor mental health as they age because of the intersectionality of gender, race and migration as well as combined forms of structural inequality (migration, social and linguistic isolation and financial insecurity). • Sexual orientation, race and mental health • Evidence suggests that Lesbian, Gay, Bisexual and Transgender (LGBT) people are at higher risk of common mental health disorders, marginalisation and issues related to ‘coming out’ • The recent Stonewall survey founds rates of depression to be high amongst LGBT people surveyed and much higher for those who had experienced a hate crime based on their sexual orientation. BME LGBT people were amongst those most likely to have higher rates of depression and eating disorders (Stonewall, 2018).

3. Sexual orientation, race and mental health • Key indicators such as education, migrant status, age, were associated with poor mental health for gay and bisexual men. Black and Asian bisexual men still had higher risk of depression and of suicide attempts than their white counterparts • Recent review on local action to address inequalities had limited evidence of intersectionality of ethnicity for bisexual and lesbian women (PHE 2018). However, one study has highlighted the impact of ‘minority stress’ on black bisexual women’s mental health. • Some evidence on the Transgender community and mental health suggests a high use of mental health services but is extremely limited in exploration of race, Transgender and mental health.

4. Summary • Limited data • It is not always clear which intersectional factor made the difference in mental health experiences • Better collation and monitoring of data to help analyse and address intersectionality and racial disparities in mental health • More research is needed to understand the impact of different of intersectional factors on mental health, how they intersect and what interventions can be developed