Examining intersectionality as a critical framework when applied to adolescent mental health

Intersectionality is concerned with processes of power and oppression emerging at the intersections of social categories such as gender and ethnicity. Given the psychological impact of oppression and inequality, understanding intersectional effects on health outcomes is of relevance to practice and policy. While intersectionality is a growing framework in clinical psychology, its application to adolescent mental health is still under-researched. The present thesis thus sought to examine the effects of social categories, processes, and determinants within intersectionality’s framework, on adolescent mental health outcomes. Firstly, to explore mental health more deeply as experienced through the complex social category of ethnicity, a qualitative systematic review of 17 academic and non-academic studies centralising adolescents’ voices was conducted. The narrative synthesis highlighted contexts, processes, and determinants effecting the mental health of adolescents from ethnically and culturally diverse backgrounds, notably discrimination, social inequalities, and interpersonal connection. However, unique intersectional effects were not explicitly examined in this study. Thus, a quantitative empirical study was conducted in an Irish secondary-school sample of 9,011 adolescents from diverse backgrounds to examine the intersectional effects of gender, sexual orientation, ethnicity, and disability on adolescent mental health. Multilevel Analysis of Individual Heterogeneity and Discriminatory Analysis (MAIHDA) examined the intersectional effects of these social categories on mental health outcomes, and a series of fixed-effects models were also conducted to investigate the individual effects of social categories and risk/protective determinants on adolescents’ mental health. Significant intersectional effects were not observed for the four social categories. Instead, significant effects for determinants such as bullying, discrimination, and connectedness to school emerged, reflecting the systematic review. The present thesis demonstrated that while it is important to remain cognisant of intersectionality, there are salient determinants reflecting oppression and inequality that warrant practice and policy attention in the interest of adolescent health and wellbeing.