Purpose The concept of inequality can be described as not being treated equally to everyone else in society. While previous studies have explored the concept of inequality and its impact on mental illness, these have been primarily quantitative. The details of experiences and potential impacts of inequalities by patients prior to admission into secure care have not been investigated comprehensively using a qualitative approach, which will identify individualised factors that may contribute to the development of mental ill-health. This study aims to explore whether those with multiple disadvantages are at greater risk of developing mental illness. Design/methodology/approach A qualitative study of patients’ clinical notes upon admission to a secure in-patient facility was conducted using a thematic analytical approach to investigate the key inequalities reported by patients with mental health problems. The topic of inequality was examined by assessing the clinical notes of 21 patients who were under treatment at the time of the study. Findings The majority of patients experienced multiple inequalities which impacted negatively on their mental health status. Three main themes that were identified were – a disrupted living environment, disturbed childhood and the importance of support. The thematic analysis has shown that the majority of the patients were exposed to numerous societal disadvantages in association with challenging life events in their early years and these have impacted significantly on their subsequent well-being. Practical implications When assessing the background to mental illness, it is important to gain a deep understanding of many inequalities that patients have faced prior to them developing their condition and, in particular, how these have combined to initiate the clinical manifestation. The study highlights the importance of raising awareness of how being treated unfairly, whether based on protected or non-protected characteristics, can contribute towards people becoming disadvantaged in society and ultimately making them more vulnerable to the development of mental health difficulties. Results of the study may inform the future use of inequalities as an integral component in the development of trauma-informed care. Originality/value This is the first study, to the authors’ knowledge, to consider intersectionality and admission to mental health units by adopting qualitative approach, specifically by reviewing patients’ clinical notes.
Purpose The concept of inequality refers to being treated unfairly in society and its impact on mental illness has been explored primarily using a quantitative research approach. Patients’ lived experiences of inequalities prior to their admission to a secure care setting need to be addressed with a higher priority as they can serve to improve our understanding of the factors underlying the development of mental illness at a personal level. The aim of this study is to explore participant’s views on whether for them the experience of inequality is associated with the development of mental illness. Design/methodology/approach A qualitative study, using a thematic analytical approach, was carried out to explore patients’ lived experiences of inequalities. A total of 11 participants, who were receiving treatment in a UK secure mental health hospital, were recruited into this study. The concept of inequality was explored using semi-structured interviews. Findings Data showed that patients had experienced a variety of inequalities which had negative impact on their mental health. Four main themes were identified from thematic textual analysis – abuse and its impact, a lack of support, the issue of labelling and the importance of understanding. Practical implications Data showed that patients had experienced a variety of inequalities which had negative impact on their mental health. Four main themes were identified from thematic textual analysis – abuse and its impact, a lack of support, the issue of labelling and the importance of understanding. Originality/value This is the first study, to the best of the authors’ knowledge, to consider intersectionality and admission to mental health units by interviewing patients in secure mental health setting.
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