TY - JOUR
T1 - Intersectional discrimination, exclusion and the socio-political economy of global mental health
T2 - A systematic scoping review of the literature
AU - Burgess, Rochelle A.
AU - Chobhthaigh, Sorcha Ní
AU - Biswal, Bijayalaxmi
AU - Ceccolini, Diana
AU - Fadipe, Babatunde
AU - Khan, Denaneer
AU - Aggarwal, Neena
AU - Pabla, Ishrat
AU - Solis, Camila
AU - Pillutla, Ramya
AU - Sarkar, Piyali
AU - Frasco, Eric
AU - lemmi, Valentina
AU - Pathare, Soumitra
AU - Lund, Crick
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2025/6
Y1 - 2025/6
N2 - Social determinants literature has reinforced the importance of social landscapes to poor mental health. However, such frameworks face critique linked to their limited acknowledgement of structural determinants and the complex social processes which establish the patterns of disease. In this scoping review, we explore the extent to which the current mental health evidence base acknowledges the impact of intersectional structural determinants of mental health outcomes, via the mechanism of discrimination - linked to a range of commonly underexplored socio-political factors (Protocol registration DOI:10.17605/OSF.IO/CGJQH). We included nine social phenomena widely acknowledged in social theory as contributing to the patterning of social determinants: (1) Political Dynamics, (2) Racism, Caste & Xenophobia, (3) Gender & Sexuality, (4) Neighbourhood Dynamics, (5) Class & Working conditions, (6) Colonialism, (7) Indigeneity, (8) Religious & Spiritual Identities (9) Age & Disability. We explored these factors intersectionally, including studies with two or more factors in their analyses. Findings are reported using the PRISMA extension for Scoping Reviews Checklist. We screened 27,003 records with 118 papers meeting inclusion criteria. We found no papers exploring caste-based discrimination in relation to the factors in our framework and very few exploring discrimination linked to indigeneity, colonialism, religious institutions, and language. The majority of studies focused on racism and its intersections with sexuality, gender and working conditions. We found a near balance in qualitative and quantitative approaches to exploring intersectoral discrimination. Common mental disorders were the most explored across all studies. Based on our findings the field appears to still be in its infancy in terms of engaging with intersecting forms of discrimination as a key mechanism driving the mental health consequences of many social and structural determinants. We articulate implications for research noting the necessity of efforts that explicitly name structural factors, acknowledges their intersections in people's lives, and frameworks that support this.
AB - Social determinants literature has reinforced the importance of social landscapes to poor mental health. However, such frameworks face critique linked to their limited acknowledgement of structural determinants and the complex social processes which establish the patterns of disease. In this scoping review, we explore the extent to which the current mental health evidence base acknowledges the impact of intersectional structural determinants of mental health outcomes, via the mechanism of discrimination - linked to a range of commonly underexplored socio-political factors (Protocol registration DOI:10.17605/OSF.IO/CGJQH). We included nine social phenomena widely acknowledged in social theory as contributing to the patterning of social determinants: (1) Political Dynamics, (2) Racism, Caste & Xenophobia, (3) Gender & Sexuality, (4) Neighbourhood Dynamics, (5) Class & Working conditions, (6) Colonialism, (7) Indigeneity, (8) Religious & Spiritual Identities (9) Age & Disability. We explored these factors intersectionally, including studies with two or more factors in their analyses. Findings are reported using the PRISMA extension for Scoping Reviews Checklist. We screened 27,003 records with 118 papers meeting inclusion criteria. We found no papers exploring caste-based discrimination in relation to the factors in our framework and very few exploring discrimination linked to indigeneity, colonialism, religious institutions, and language. The majority of studies focused on racism and its intersections with sexuality, gender and working conditions. We found a near balance in qualitative and quantitative approaches to exploring intersectoral discrimination. Common mental disorders were the most explored across all studies. Based on our findings the field appears to still be in its infancy in terms of engaging with intersecting forms of discrimination as a key mechanism driving the mental health consequences of many social and structural determinants. We articulate implications for research noting the necessity of efforts that explicitly name structural factors, acknowledges their intersections in people's lives, and frameworks that support this.
KW - Discrimination
KW - Global mental health
KW - Intersectionality
KW - Social determinants of mental health
KW - Socio-political economy
UR - http://www.scopus.com/inward/record.url?scp=85214336653&partnerID=8YFLogxK
U2 - 10.1016/j.ssmmh.2024.100382
DO - 10.1016/j.ssmmh.2024.100382
M3 - Review article
AN - SCOPUS:85214336653
SN - 2666-5603
VL - 7
JO - SSM - Mental Health
JF - SSM - Mental Health
M1 - 100382
ER -