Background There is a socioeconomic gradient in mental health outcomes for young people: disadvantaged groups are more likely to suffer problems. In the UK, there is evidence of apparent resilience to mental health problems in young people from some ethnic minority groups, or lack of disadvantage despite facing greater socioeconomic adversity. This project investigated the relationship between social support, participation, and experiences of social adversity with mental health outcomes, focusing on inequalities by ethnicity, to explain any increased risk or resilience to adverse mental health outcomes.
Methods Data was analysed from 10,357 young people aged 14 taking part in the nationally representative Millennium Cohort Study. Univariable descriptive analysis assessed prevalence of mental health problems, identified using parent responses to the Strengths and Difficulties Questionnaire. Univariable logistic regression analysed crude associations of sociodemographic factors with mental health problems. Factors included: ethnicity, gender, socioeconomic status, parental relationship, time spent with friends, in organised activities, and religious attendance, self-reported social support, experience of victimisation, substance abuse, being a victim or perpetrator of bullying. Multivariable logistic regressions assessed if social factors explained any observed ethnic differences in mental health problems.
Results Social support and participation were associated with better mental health outcomes, and social adversity with worse mental health outcomes, for all cohort members at age 14. Overall, boys had increased odds for having mental health problems compared to girls (OR 1.24, 95% CI 1.05–1.46). Adjusting for socioeconomic status revealed reduced ORs for mental health problems in the Pakistani group (girls 0.63, 0.41–0.99; boys 0.49, 0.27–0.89), as well as Black African boys (0.10, 0.02–0.38), Indian boys (0.40, 0.21–0.77), and Bangladeshi girls (0.18, 0.05–0.65), compared to their White peers. After adjusting for social support, participation, and adversity factors, significantly reduced odds for mental health problems remained only for Black African boys (OR 0.16, 0.04–0.72).
Conclusion Socioeconomic status (SES) confounds resilience factors against mental health problems apparent in young people from some ethnic minority groups. Despite greater socioeconomic disadvantage, there was reduced prevalence of mental health problems for these young people after adjustment for SES. Furthermore, the changes to ORs after adjusting for social support, participation, and adversity factors suggest ethnic inequalities in mental health outcomes in this sample could be partly explained by these social factors. Further analysis is needed to investigate mediating mechanisms operating here. Social interventions may help foster resilience in young people against mental health problems, irrespective of ethnicity.
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