Journal
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
Volume 57, Issue 2, Pages 245-254Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00127-021-02123-8
Keywords
Adolescent; Mental health; Social inclusion; Protective factors; Risk factors; Primary health care
Categories
Funding
- National Health and Medical Research Council (NHMRC) [APP1076940]
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This study examines the importance of social inclusion in enhancing mental healthcare for young people. It found that some young people may experience social exclusion across multiple domains and report more mental health problems. The co-occurrence of mental ill-health and social exclusion emphasizes the significance of integrated mental healthcare.
Background headspace centres provide enhanced primary mental healthcare for young people. A priority is to provide services for all young people irrespective of a range of social disadvantages or social exclusion. The aims of this study were to: (i) delineate extent of social inclusion across domains of housing, studying/employment, functioning, alcohol, and other drug use; and (ii) map profiles of young people deemed vulnerable to experiencing additional barriers to accessing services based on their social inclusion domains (e.g., those living in unstable housing, not in employment/education, and/or experiencing intersecting or multiple forms of disadvantage or difficulties), including detailing their clinical characteristics. Methods Young people were recruited from five headspace centres. Data relevant to social inclusion were examined. Multivariate logistic regression models were used to determine overlap between vulnerable groups, functional, social, clinical, and behavioural factors. Results 1107 young people participated, aged 12-25 years (M = 18.1 years, SD = 3.3), most living in stable housing (96.5%) and engaged in studying/employment (84.8%). Specific vulnerabilities were evident in young people with NEET status (15.2%); in unstable accommodation (3.5%); of culturally diverse backgrounds (CALD) (12.2%); living in regional areas (36.1%); and identifying as lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual plus (LGBTIQA+; 28.2%). Higher levels of distress, substance use, functional impairment, and lower social support were reported by those who were NEET and/or in unstable housing. LGBTIQA+ status was associated with high distress, depressive symptoms, and suicidal ideation. Conclusions Most participants reported good social support, stable housing, and engagement in work or education. Those deemed vulnerable were likely to experience social exclusion across multiple domains and reported more mental health problems. The co-occurrence of mental ill-health and social exclusion highlights the importance of integrated mental healthcare.
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