{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:29:15Z","timestamp":1787315355116,"version":"build-2736575974"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>This study investigates the association between protected characteristics and inequalities in mental health care in the UK. Multinomial regression was used to model the association between protected characteristics and self-reported distress. Data was extracted from waves 6\u201310 (2014\u20132019) of the UK Household Longitudinal Study. Two risk categories were constructed: \u201cundiagnosed distress\u201d referred to a General Health Questionnaire-12 (GHQ-12) score above \u201ccaseness\u201d along with no history of mental health diagnosis; \u201cdiagnosis without self-report symptoms\u201d referred to a GHQ-12 score consistently below \u201ccaseness\u201d within the study time frame but having received a mental health diagnosis. Compared to people without a disability, people with a disability are at considerably greater risk of both undiagnosed distress (Relative risk ratios (RRR) 2.76; Confidence Interval (CI): 2.55, 2.99) and diagnosis without self-reported symptoms (RRR 3.61; CI: 2.80, 4.66). Likewise, women were more likely than men to report undiagnosed distress (RRR = 1.49; CI: 1.38,1.61) or a diagnosis without self-reported symptoms (RRR = 1.38; CI: 1.08, 1.76. Lesbian, gay, and bisexual people are at greater risk of undiagnosed distress compared with heterosexual people (RRR 1.42; CI: 1.19, 1.70). Adults aged 16\u201324 years were at greatest risk compared to all other age groups. People from a minority ethnic background had a reduced risk of diagnosis without self-report symptoms compared with people from a White ethnic background (RRR 0.34; CI: 0.20, 0.61). Education, employment and income variables moderated some of these associations. This is the first study to examine diagnosis without self-report symptoms alongside undiagnosed distress. Findings suggest that addressing inequality in mental health care requires increased understanding of the needs and strengths within different groups and to provide appropriate forms of social, medical or psychosocial intervention rather than a singular focus on increasing detection, diagnosis and treatment. People with a disability appear to be at greatest disadvantage, requiring greater attention in policy and practice.<\/jats:p>","DOI":"10.1371\/journal.pone.0308279","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T13:44:10Z","timestamp":1722951850000},"page":"e0308279","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Are protected characteristics associated with mental health care inequalities in the adult UK general population? a cross-sectional study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-5373","authenticated-orcid":true,"given":"Claire","family":"Wicks","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Booker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Kumari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Trotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"pone.0308279.ref001","volume-title":"Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014.","author":"S McManus","year":"2016"},{"key":"pone.0308279.ref002","article-title":"The long term plan","author":"NHS England","year":"2019"},{"key":"pone.0308279.ref003","author":"The King\u2019s Fund","year":"2023","journal-title":"What are health inequalities?"},{"key":"pone.0308279.ref004","article-title":"Ethnic Inequalities in Healthcare: A Rapid Evidence Review","author":"D Kapadia","year":"2022"},{"key":"pone.0308279.ref005","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1037\/prj0000537","article-title":"Experiences of adults from a Black ethnic background detained as inpatients under the Mental Health Act (1983).","volume":"46","author":"J Solanki","year":"2023","journal-title":"Psychiatric Rehabilitation Journal"},{"key":"pone.0308279.ref006","year":"2023","journal-title":"Detentions under the Mental Health Act"},{"issue":"4","key":"pone.0308279.ref007","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1192\/bjp.bp.113.137547","article-title":"Pathways of care of women in secure hospitals: which women go where and why","volume":"205","author":"A Bartlett","year":"2014","journal-title":"The British Journal of Psychiatry"},{"key":"pone.0308279.ref008","author":"Department of Health and Social Care","year":"2018","journal-title":"The Women\u2019s Mental Health Taskforce Final Report"},{"issue":"5","key":"pone.0308279.ref009","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence.","volume":"129","author":"IH Meyer","year":"2003","journal-title":"Psychological Bulletin"},{"key":"pone.0308279.ref010","article-title":"National LGBT survey research report.","author":"Government Equalities Office","year":"2018"},{"key":"pone.0308279.ref011","article-title":"LGBT in Britain: Health Report","author":"CL Bachmann","year":"2018"},{"issue":"8","key":"pone.0308279.ref012","doi-asserted-by":"crossref","first-page":"e016614","DOI":"10.1136\/bmjopen-2017-016614","article-title":"Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data","volume":"7","author":"S Dikaios","year":"2017","journal-title":"BMJ Open"},{"key":"pone.0308279.ref013","article-title":"Disabled people struggling to access GP appointments","author":"Health Watch","year":"2015"},{"key":"pone.0308279.ref014","article-title":"Suffering in silence: age inequality in older people\u2019s mental health care.","author":"Royal College of Psychiatrists","year":"2018","journal-title":"College Report CR211"},{"key":"pone.0308279.ref015","article-title":"Better access to mental health services for older people","author":"A. 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