Cumulative Risk of Undiagnosed Mental Distress in the UK General Population: The Role of Protected Characteristics

This study explores cumulative risk and mental health care inequalities focusing on “at-risk” protected characteristics. Data was extracted from the UK Household Longitudinal Study (2009–2022). Respondents were categorised by the number of “at-risk” characteristics (0 to 5+). The relationship between number of “at-risk” protected characteristics and mental distress measured via the General Health Questionnaire-12 was explored using linear regression. Mental distress increased with the accumulation of two or more at-risk characteristics, with larger coefficients evident for men. The relationship between undiagnosed mental distress and number of “at-risk” protected characteristics was explored using multinomial regression. Risk of undiagnosed mental distress increased with the accumulation of one or more "at-risk" characteristics for both men and women. Men with 5+ protected characteristics (RRR = 8.84) and women with four protected characteristics (RRR = 4.03) experienced greatest risk of undiagnosed mental distress. Descriptive analysis revealed increased risks for younger, disabled and/or gay or bisexual men; and younger, ethnic minority and/or lesbian or bisexual women. Findings suggest that young lesbian, gay and bisexual people may experience greatest disadvantage in relation to access to NHS mental health care and that young gay or bisexual men with a disability experience extreme disadvantage relative to other men.