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Exploring variations in mental health service use by men from an intersectional perspective

Smyth, Natasha Therese; (2021) Exploring variations in mental health service use by men from an intersectional perspective. Doctoral thesis (D.Clin.Psy), UCL (University College London). Green open access

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Abstract

Background: Men’s reticence to seek help for mental health problems is well documented. Less is known about patterns of engagement once they have made initial contact with services and whether there is variation in relation to sociodemographic and socioeconomic characteristics. This study will employ an intersectional approach to investigate how multiple sociodemographic and socioeconomic indicators interact to increase and decrease the likelihood of male service users’ engagement with psychological treatment services. Method: Routinely collected data from 9,904 male service users accessing two psychological treatment services in two diverse London boroughs was analysed for this study. Latent Class Analysis (LCA) was used to identify subgroups of male service users by ethnicity, sexual orientation, religious affiliation and employment status. Multinomial logistic regression was used to explore associations between service use outcomes and both individual social status indicators and the identified classes. Results: Regression analyses revealed that being Black, Asian, Muslim as well as unemployed conferred a greater risk of not commencing or completing treatment for men in this sample. LCA identified seven subgroups of men differentiated predominately by ethnicity and religious group membership, with sexual orientation and employment status distributions staying broadly similar across classes. The ‘Asian Muslim’ class and the ‘BAME non-religious’ class were at higher risk of disengagement, whilst the ‘Asian other religion’ class were at higher risk of being referred elsewhere rather than completing initiated treatment. Post-hoc interaction analysis revealed that younger men from the ‘BAME Christian’ group were at higher risk of being deemed unsuitable for treatment. Conclusions: Results reveal significant inequalities in the mental health service use of men by ethnic and religious group and markers of socioeconomic status. Compared with the regression models, LCA revealed further nuance regarding the intersection of gender, religion and ethnicity. However, associations between employment status and service use revealed in regression modelling did not feature in the LCA results, meaning a potentially important source of disadvantage could be overlooked if the LCA had been the sole analytic model used.

Type: Thesis (Doctoral)
Qualification: D.Clin.Psy
Title: Exploring variations in mental health service use by men from an intersectional perspective
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10123977
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