Racial inequalities in mental health help-seeking among young people in the covid-19 context.

COVID-19 PhD Scholarship 2022


Supervisors: Stephani Hatch and Gemma Knowles


Lay Summary: Black and other racialised communities in the UK are at increased risk of severe mental illness and are disproportionately detained involuntarily under the Mental Health Act. They are also less likely to receive and to seek support for their mental health. Adolescence is the period in which most mental health problems first emerge, so early support and intervention for those experiencing mental distress in adolescence may help prevent longer term problems. We know very little, though, about mental health help-seeking patterns among Black adolescents, and we know even less about the impacts of the pandemic on racial inequalities in help-seeking. This is important because we do know that Black (and other racialised) groups, particularly those in poverty, have been most impacted by the social, economic, and health consequences of the pandemic. Understanding and dismantling barriers to help-seeking among Black YP in the context of COVID-19, then, is a public health priority, but we lack high quality evidence on this topic. The proposed project will address this knowledge gap. Working together with Black YP and with schools, this project – embedded within our ongoing cohort study of adolescent mental health in diverse urban areas, REACH – will generate important and robust information about (a) the extent and nature of, and barriers to, mental health help-seeking among young people from diverse racial and social backgrounds, before and during/after the COVID-19 pandemic, (b) whether racial inequalities in mental health help-seeking widened during the pandemic, and (c) what needs to change to reduce these inequalities.


Aim: To examine patterns of mental health help-seeking, and barriers to mental health support, among Black YP, before and during/after the COVID-19 pandemic.


Specific objectives:

1. To estimate the prevalence and nature of, and inequalities in, mental health help-seeking in large, representative, racially diverse cohorts of secondary school students across 6 time points, 3 pre-covid (2016-19) and 3 mid/post covid (2020-22);

2. To explore, in-depth, the lived experience of Black YP in accessing and receiving mental health support across contexts (i.e., in school, the community, online, and clinical services);

3. To co-create with Black YP a culturally sensitive toolkit to be used in schools to improve understanding of and dismantle barriers to in-school mental health support.


Hypotheses (H):

H1. At all timepoints, Black YP will be less likely to seek and to receive help for their mental health compared with White YP, and this racial disparity will be greater among girls than among boys;

H2. During the pandemic, inequalities in help seeking between Black and White YP will (at least initially) widen, particularly among those living in low-income households (i.e., on free school meals);

H3. Social psychological factors such as in-group norms and discrimination are prominent barriers to help-seeking among Black YP.