Relational Inequalities that Influences Mental Health

Relational Inequalities that Influences Mental Health

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Being communally linked is strongly linked to good mental health outcomes; access to positive relationships from an early age is essential to our growth, as well as our physical wellness and contentment across life. On the contrary, many of the main dangers to mental health also include social relationships – for example, experiencing discrimination and social segregation based on race, gender, sexual orientation, or experiences of adverse events in childhood and adulthood, including trauma, sexual abuse or maltreatment, violence, domestic abuse, parental separation, grief, and isolation.

Cultural/Social Group Status

Identifying with a specific cultural or social group can bring with it a higher risk of mental health problems when it leads to unpleasant experiences. Sometimes these risks are linked to experiences of intolerance and prejudice, but it can also arise from greater exposure to experiences such as bullying, hate crime, domestic violence or abuse, or other types of trauma.


Refugees and asylum seekers are more likely to experience mental health problems than the general population, this includes higher levels of depression, post-traumatic stress disorder (PTSD) and other anxiety disorders.


Being a victim of racism is widely associated with mental health challenges. The emotional and psychological effects of racism have been described as consistent with traumatic stress and the negative

effects are cumulative. Racism and a lack of cultural awareness may also contribute to the bias experienced by people from BAME communities when seeking help from mental health services.


One review found that sexual minority individuals were almost four times more likely to experience sexual abuse, and also more probable to encounter parental physical abuse, to come into contact with assault at school, and subsequently skip school days out of fear. For transgender people, the available studies suggest even high rates of negative mental health outcomes. Gender also influences an individual’s mental health risk. Rates of self-harm amongst young women multiplied by three between 1993 and 2014, and young women are more likely to suffer PTSD or eating disorders. Just over three out of four suicides (76%) are from men, and males are also more likely than women to become alcohol-dependent.


Stigma is all-too-familiar for those with mental health problems. Stigma can include lack of knowledge (ignorance), attitude (prejudice) and behaviour (discrimination). Statistically nine out of ten people with mental health problems have experienced stigma or discrimination either at work, in education, from professionals or at home. Facing stigma and discrimination can have a very negative impact on those with mental health problems, creating significant barriers to accessing a good quality of life and achieving wellbeing.

Adverse Childhood Experiences

Adversity in childhood is directly responsible for 29.8% of adult mental health problems, with evidence showing that the more severe and prolonged the exposure to adversity, the greater the risk of developing a mental health problem.

ACE’s have been defined as “stressful experiences occurring during childhood that directly hurt a child (for example maltreatment) or affect them through the environment in which they live (like growing up in a house with domestic violence)”. Typical ACE’s can include experiencing physical, sexual or verbal abuse, violence, parental separation, mental illness in the household, alcohol or substance misuse, or imprisonment of a family member.

Sexual abuse in childhood increases the risk of most mental health problems, including PTSD, suicide, depression, anxiety, low self-esteem, OCD, phobias, substance abuse, eating disorders and personality disorders. People in the most deprived financial groups were almost three times more likely to have experienced four or more ACE’s compared to those in the most affluent groups.

Study has shown that poor or insecure family attachment is associated with depression, anxiety, PTSD, suicidal thoughts or behaviours, and eating disorders. Parental mental health problems and substance abuse can also diminish their capability to provide everyday practical and emotional care to their children, which can have somber consequences for the children.  It can also mean that young people have to take care of their parents as they become older.

Adverse Experiences in Adulthood

Suffering two or more adverse life events as a grown up – such as serious illness, job loss or grief – is also connected with mental health problems. Adverse experiences in a later stage of life can often be more difficult to cope with, especially if someone has also experienced adversity in childhood.

Being a victim of hate crime or other types of social trauma are also major contributors to mental health problems.


Loneliness in adulthood is an important risk factor for both deteriorating mental health and suicide. Adults under 60 who live alone are found to be more likely to have suicidal thoughts than those of the same age who were living with others. Older adults who have experienced loss by being widowed or divorced are more likely to exhibit heightened symptoms of depression and poorer physical functioning, as well as to face a greater mortality risk than their married counterparts.

These are a few valid examples of the value of a relational approach in the study of inequality. Studying the impact of different areas of inequality and it’s influence on mental health, will improve not only our understanding of inequality but, most importantly, our efforts to reduce the mental health effects of it.

Read more about mental health.


1. Porter M, Haslam N. – Pre-displacement and post-displacement factors associated with mental health of refugees and internally displaced persons: A meta analysis. J Am Med Assoc. 2005

2. Lewis TT, Cogburn CD, Williams – Self-Reported Experiences of Discrimination and Health: Scientific Advances, Ongoing Controversies, and Emerging Issues. Annu Rev Clin Psychol. 2015

3. Carter RT. Racism and Psychological and Emotional Injury: Recognizing and Assessing Race-Based Traumatic Stress. CounsPsychol. 2007

4. Ploderl M, Tremblay P. Mental health of sexual minorities. A systematic review.2015

5. Friedman MS, Marshal MP, Guadamuz TE, Wei C, Wong CF, Saewyc EM, et al. A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. Am J Public Health. 2011

6. Mental Health Foundation. Stigma & discrimination [Internet]. uk/a-to-z/s/stigma-and-discrimination

7. Bellis MA, Ashton K, Hughes K, Ford K, Bishop J, Paranjothy S. Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population: Alcohol use, drug use, violence, sexual behaviour, incarceration, smoking and poor diet. 2015.

8. Mental Health Foundation. The Lonely Society? London; 2010.

9. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspect Psychol Sci. 2015

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