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 adolescenceduring teenage years may help prevent longer term problems. We know very little, though, about mental health help-seeking patterns among Black adolescentsteenagers, 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 teenagers 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 –It  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 peopleteenagers 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. Working together with Black teenagers and with schools, the student will (1) analyse existing help-seeking data  – 3 pre-pandemic and 3 mid-pandemic waves – from REACH (www.thereachstudy.com), our ongoing study of mental health among adolescents from diverse backgrounds in London, (2) conduct in-depth interviews and focus groups with Black teenagers to understand the barriers and facilitators to help seeking, and (3) co-develop and pilot a culturally sensitive toolkit for schools.


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. 

Research Student: Esther Putzgruber

My name is Esther Putzgruber and I will be starting my PhD at King’s College London in October 2022.

I completed my BSc Criminology at the University of Derby and shortly after, completed a MSc in Forensic Mental Health at Nottingham Trent University. I then joined King’s College London at the Institute of Psychiatry, Psychology and Neuroscience in October 2020, where I was granted the opportunity to work as a Research Assistant on The Resilience, Ethnicity and AdolesCent Mental Health (REACH) Study. This study aims to understand the best ways to promote good mental health among young people from all backgrounds. Working with REACH has enabled me to continue to develop a strong understanding and interest in social and ethnic inequalities in mental health.


In the UK, rates of mental health difficulties amongst Black and minority ethnic groups are found to be disproportionately higher than their white counterparts, and additional disparities have been highlighted in the routes to mental health support for Black people. Where research into help-seeking disparities amongst Black adolescents is scarce, I am excited and grateful for the opportunity to be a part of this project; to help amplify Black young voices and work towards providing effective, culturally appropriate mental health support for adolescents from all ethnic communities.