Mental health and wellbeing strategy: executive summary

Addressing mental health inequalities

We will lay out actions in our Delivery Plan which are designed to make substantial progress towards tackling mental health inequalities. These actions will continue to evolve over time.

"Health inequalities are the unjust and avoidable differences in people's health across the population and between different population groups." Source: Scottish Parliament Health Inequalities Inquiry 2022

Some groups of people have poorer mental health than others. These health inequalities are a symptom rather than the cause of the problem. The causes of health inequalities arise from the unequal distribution of income, wealth and power, which can impact on wider life chances and experiences.

These societal conditions put some groups at greater risk of poor mental health than others. These conditions are commonly known as 'social determinants' and include traumatic and adverse experiences such as poverty, discrimination, loneliness, unemployment, lack of adequate housing, and lack of social and cultural opportunities.

Social and structural inequality in society means that those who face the most significant disadvantages in life also face the greatest risks to their mental health. This includes marginalised groups who experience discrimination, racism or exclusion (social, political, economic or environmental) solely based on age, race, sex, sexual orientation, disability or other characteristics protected by the Equality Act 2010.^[1] There are also other groups, such as veterans, refugees, children, young people, adults and families who are care experienced, people affected by substance use, those experiencing abuse or homelessness and those engaged in the justice system. Many people in these marginalised or hidden groups experience discrimination from parts of society, creating multiple discrimination and leading to significant marginalisation. This can be traumatic and cause long-term damage to their mental health and considerable adverse mental health impacts beyond those that the rest of the population face.

In many cases, these same groups of people also often experience less access to effective and relevant support for their mental health. When they do get support, their experiences and outcomes can be poorer. These inequalities in mental healthcare can exacerbate mental health inequalities.

We must take an intersectional approach, recognising that people are multi-faceted. Different experiences or aspects of their identity interact to affect their mental health, so we can most effectively understand and tackle structural inequality and health inequalities, including racialised and gendered inequality. We need support, services, care and treatment that are person-centred, anti-racist, culturally and gender sensitive, age-appropriate, fully inclusive and in a range of formats.