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Social inclusion, intersectionality, and profiles of vulnerable groups of young people seeking mental health support

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Abstract

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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References

  1. Productivity Commission (2019) The social and economic benefits of improving mental health. Australian Government, Canberra

    Google Scholar 

  2. Filia K et al (2018) What is social inclusion? A thematic analysis of professional opinion. Psychiatr Rehabil J 41:183–195

    Article  Google Scholar 

  3. Patton GC et al (2016) Our future: a Lancet commission on adolescent health and wellbeing. Lancet 387(10036):2423–2478

    Article  Google Scholar 

  4. McGorry PD et al (2011) Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry 24(4):301–306

    Article  Google Scholar 

  5. Vinson T (2009) Social inclusion: the origins, meaning, definition of and economic implications of the concept social inclusion/exclusion. Commonwealth of Australia, Canberra. http://pandora.nla.gov.au/pan/142909/20130920-1300/www.socialinclusion.gov.au/sites/default/files/publications/pdf/economic-implications.pdf

    Google Scholar 

  6. Shepherd G, Parsonage M (2011) Measuring the costs and benefits of promoting social inclusion. Ment Health Soc Incl 15(4):165–174

    Article  Google Scholar 

  7. Lund C et al (2011) Poverty and mental disorders: breaking the cycle in low-income and middle income countries. Lancet 378:1502–1514

    Article  Google Scholar 

  8. McGorry P et al (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40(8):616–622

    Article  Google Scholar 

  9. Rickwood D et al (2015) The services provided to young people through the headspace centres across Australia. Med J Aust 202(10):533–536

    Article  Google Scholar 

  10. headspace (2019) headspace annual report 2018–19. headspace National Youth Mental Health Foundation, Melbourne, pp 1–5

    Google Scholar 

  11. Hughes F et al (2018) Ten guiding principles for youth mental health services. Early Interv Psychiatry 12(3):513–519

    Article  Google Scholar 

  12. Hetrick SE et al (2017) Integrated (one-stop shop) youth health care: best available evidence and future directions. Med J Aust 207(10):S5–S18

    PubMed  Google Scholar 

  13. McGorry P, Trethowan J, Rickwood D (2019) Creating headspace for integrated youth mental health care. World Psychiatry 18(2):140

    Article  Google Scholar 

  14. Rickwood D et al (2015) Service innovation project component 2: social inclusion model development study. headspace National Youth Mental Health Foundation, Melbourne

    Google Scholar 

  15. Brown A et al (2016) Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people. Asia Pac Psychiatry 8(1):3–22

    Article  Google Scholar 

  16. Mustard CA et al (2013) Mortality following unemployment in Canada, 1991–2001. BMC Public Health 13(1):441

    Article  Google Scholar 

  17. Wanberg CR (2011) The individual experience of unemployment. Annu Rev Psychol 63(1):369–396

    Article  Google Scholar 

  18. Seng JS et al (2012) Marginalized identities, discrimination burden, and mental health: empirical exploration of an interpersonal-level approach to modeling intersectionality. Soc Sci Med 75(12):2437–2445

    Article  Google Scholar 

  19. Gardner A et al (2019) The social inclusion of young people with serious mental illness: a narrative review of the literature and suggested future directions. Aust N Z J Psychiatry 53(1):15–26

    Article  Google Scholar 

  20. Filia K et al. (2021) Clinical and functional characteristics of a subsample of young people presenting for primary mental healthcare at headspace services across Australia. Soc Psychiatry Psychiatr Epidemiol https://doi.org/10.1007/s00127-020-02020-6

  21. Cutrona CE, Russell DW (1987) The provisions of social relationships and adaptation to stress. Adv Pers Relatsh 1(1):37–67

    Google Scholar 

  22. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613

    Article  CAS  Google Scholar 

  23. Kessler R et al (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 32(6):959–976

    Article  CAS  Google Scholar 

  24. Reynolds WM (1987) Suicidal Ideation Questionnaire (SIQ). Psychological Assessment Resources, Odessa

    Google Scholar 

  25. WHO Assist Working Group (2002) The alcohol, smoking and substance involvement screening test (ASSIST): development, reliability and feasibility. Addiction 97(9):1183–1194

    Article  Google Scholar 

  26. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association, Arlington

    Book  Google Scholar 

  27. Goldman HH, Skodol AE, Lave TR (1992) Revising axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 149:9

    Article  Google Scholar 

  28. Buuren SV, Groothuis-Oudshoorn K (2010) Multivariate imputation by chained equations in R. J Stat Softw 45:1–68

    Google Scholar 

  29. Australian Bureau of Statistics (2016) Census of population and housing: estimating homelessness, in 2049.0. Australian Bureau of Statistics, Canberra

    Google Scholar 

  30. Webber M, Fendt-Newlin M (2017) A review of social participation interventions for people with mental health problems. Soc Psychiatry Psychiatr Epidemiol 52(4):369–380

    Article  Google Scholar 

  31. Wang J et al (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 18(1):156

    Article  Google Scholar 

  32. Thoits PA (2011) Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav 52(2):145–161

    Article  Google Scholar 

  33. Kuosmanen T et al (2017) A pilot evaluation of the SPARX-R gaming intervention for preventing depression and improving wellbeing among adolescents in alternative education. Internet Interv 8:40–47

    Article  CAS  Google Scholar 

  34. Benjet C et al (2012) Youth who neither study nor work: mental health, education and employment. Salud Publica Mex 54(4):410–417

    Article  Google Scholar 

  35. O’Dea B et al (2014) A cross-sectional exploration of the clinical characteristics of disengaged (NEET) young people in primary mental healthcare. BMJ Open 4(12):e006378

    Article  Google Scholar 

  36. Gutiérrez-García RA et al (2017) NEET adolescents grown up: eight-year longitudinal follow-up of education, employment and mental health from adolescence to early adulthood in Mexico City. Eur Child Adolesc Psychiatry 26(12):1459–1469

    Article  Google Scholar 

  37. Fattoracci ESM, Revels-Macalinao M, Huynh Q-L (2020) Greater than the sum of racism and heterosexism: intersectional microaggressions toward racial/ethnic and sexual minority group members. Cultur Divers Ethnic Minor Psychol 27:176–188

    Article  Google Scholar 

  38. Baams L, Grossman AH, Russell ST (2015) Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Dev Psychol 51(5):688–696. https://doi.org/10.1037/a0038994

    Article  PubMed  PubMed Central  Google Scholar 

  39. Lea T, de Wit J, Reynolds R (2014) Minority stress in lesbian, gay, and bisexual young adults in Australia:associations with psychological distress, suicidality, and substance use. Arch Sex Behav 43(8):1571–1578. https://doi.org/10.1007/s10508-014-0266-6

    Article  PubMed  Google Scholar 

  40. Australian Bureau of Statistics (2016) Census of population and housing: reflecting Australia—stories from the census, 2016. https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2071.02016?OpenDocument. Cited 16 Aug 2020

  41. Hilferty F et al (2015) Is headspace making a difference to young people’s lives? Final report of the independent evaluation of the headspace program. Social Policy Research Centre, Sydney

    Google Scholar 

  42. Minas H (2018) Mental health in multicultural Australia. In: Moussaoui D, Bhugra D, Ventriglio A (eds) Mental health and illness in migration. Springer, Singapore

    Google Scholar 

  43. de Anstiss H, Ziaian T (2010) Mental health help-seeking and refugee adolescents: qualitative findings from a mixed-methods investigation. Aust Psychol 45(1):29–37

    Article  Google Scholar 

  44. headspace, Headspace Annual Report: 2016-17, Australian Government Department of Health. headspace National Youth Mental Health Foundation: Melbourne, Australia.

  45. Filia K et al (2019) Developing and testing the F-SIM, a measure of social inclusion for people with mental illness. Psychiatry Res 279:1–8

    Article  Google Scholar 

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Acknowledgements

This was a joint project between Orygen; Centre for Youth Mental Health (University of Melbourne) and headspace National Youth Mental Health Foundation. We thank Dr Sharnel Perera for her contributions in many aspects of the project and the team of research assistants involved in collecting the data. We thank the headspace centre staff and young people whose participation made this study possible.

Funding

The study was supported by a National Health and Medical Research Council (NHMRC) Partnership Grant (APP1076940).

Author information

Authors and Affiliations

  1. Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia

    K. Filia, J. Menssink, C. X. Gao, M. Hamilton, S. E. Hetrick, A. G. Parker, H. Herrman, S. Sharmin, P. D. McGorry & S. M. Cotton

  2. Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia

    K. Filia, J. Menssink, C. X. Gao, H. Herrman, S. Sharmin, P. D. McGorry & S. M. Cotton

  3. Department of Epidemiology and Preventative Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    C. X. Gao

  4. headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia

    D. Rickwood

  5. Faculty of Health, University of Canberra, Canberra, ACT, Australia

    D. Rickwood

  6. Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand

    S. E. Hetrick

  7. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia

    A. G. Parker

  8. Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia

    I. Hickie

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  1. K. Filia
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  2. J. Menssink
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  10. S. Sharmin
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  11. P. D. McGorry
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Corresponding author

Correspondence to K. Filia.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Filia, K., Menssink, J., Gao, C.X. et al. Social inclusion, intersectionality, and profiles of vulnerable groups of young people seeking mental health support. Soc Psychiatry Psychiatr Epidemiol 57, 245–254 (2022). https://doi.org/10.1007/s00127-021-02123-8

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  • DOI: https://doi.org/10.1007/s00127-021-02123-8

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