Measures for intersectional mental healthcare: results from a participatory interview and focus group study with psychosocial counsellors, people with experience of using mental health services and providers

Abstract

BACKGROUND: Discriminatory practices and barriers to care are increasingly recognised as a significant challenge for mental healthcare institutions. Yet, little research has considered what measures people with experience of using mental health services and mental healthcare service providers recommend to implement anti-discrimination within mental healthcare. AIMS: This study aims to explore the perspectives and recommendations of marginalised people with experience of using mental health services, mental healthcare service providers and psychosocial counsellors, to inform more equitable mental healthcare. METHOD: Between May 2022 and June 2023, we conducted 17 semi-structured qualitative interviews and 2 focus groups with psychosocial counsellors, people with experience of using mental health services and mental healthcare service providers. Data analysis followed structuring qualitative content analysis, combined with participatory methods. RESULTS: Study participants recommended interpersonal, organisational and structural measures to address mental healthcare inequities. On an interpersonal level, they emphasised providers' behaviour and attitudes toward discrimination. Organisationally, they called for a comprehensive intersectional care framework, fostering inclusive therapy environments, increasing staff diversity and implementing continuous anti-discrimination training. Structurally, they advocated for discrimination-critical therapy materials, revised curricula and removing barriers to medical education and healthcare. CONCLUSIONS: The study yielded suggestions for anti-discriminatory, critical consciousness-based and inclusive practices on the interpersonal, organisational and structural levels of mental healthcare. It offers important insights for research devoted to implementing and evaluating such measures.