Disparities in Mental Health and Well-Being

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Special Issue Information

Dear Colleagues,

Disparities in mental health and well-being refers to differences in the prevalence, access to resources, treatment, and outcomes related to mental health and emotional well-being among different groups of people. These disparities can manifest along various dimensions, such as:

  • Socioeconomic Status: Individuals from lower socioeconomic backgrounds may face more significant mental health challenges due to limited access to mental health care, higher stress levels related to financial difficulties, and fewer resources for coping and support;
  • Race and Ethnicity: Minority groups often experience disparities in mental health due to factors such as discrimination, cultural barriers to accessing care, and historical trauma;
  • Geographic Location: Disparities in mental health services can exist between urban and rural areas, with rural populations often limited in access to mental health care facilities and resources.
  • Age: Different age groups may face distinct mental health challenges, with adolescents and the elderly particularly vulnerable to mental health disparities;
  • Gender: Men and women may experience mental health disparities differently, with women more likely to seek help for mental health issues, while men are more likely to suffer from undiagnosed mental health conditions. In addition, nonbinary and transgender individuals may be at higher risk of minority stress and mental health issues than gender-conforming people;
  • Sexual identification: LGBTQ+ minorities may experience mental health disparities due to stigma, discrimination, and a lack of culturally competent mental health services;
  • Disability: Individuals with physical or intellectual disabilities may face added challenges in accessing mental health care, and may have unique mental health needs;
  • Trauma and Adverse Life Events: People who have experienced trauma or adverse life events, such as violence, abuse, natural disasters, military invasion, or war, may be at a higher risk of mental health disparities.

Addressing mental health disparities requires a comprehensive approach that involves policymakers, health care providers, communities, and researchers from various disciplines of public health and social science, including psychology, psychiatry, pedagogy, and sociology. We invite authors to submit various types of articles, including original research, brief studies, reviews, and meta-analyses. Topics may include, but are not limited to:

  • Research on the prevalence of mental health problems and the well-being of disadvantaged groups around the world;
  • Research focused on better-understanding the causes and effects of mental health disparities;
  • Strategies for increasing awareness and reducing stigma surrounding mental health issues;
  • Improving access to affordable and culturally competent mental health services in underserved areas;
  • Providing mental health education and resources in schools and workplaces;
  • Promoting mental health screenings and interventions targeted at vulnerable populations;
  • Integrating mental health care into primary care settings to increase access;
  • Developing public policies that prioritize mental health and well-being.

Prof. Dr. Aleksandra Rogowska
Guest Editor

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Keywords

  • age disparities
  • anxiety
  • armed conflict
  • depression
  • disability
  • disaster
  • distress
  • earthquake
  • ethnicity disparities
  • flood
  • gender disparities
  • geographic region
  • health disparities
  • LGBTQ+
  • mental health
  • physical health
  • post-traumatic stress disorder
  • quality of life
  • sexual identification
  • socioeconomic status
  • stress
  • well-being
  • war

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Published Papers (8 papers)

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Research

14 pages, 295 KiB  
Article
Parents’ and Children’s Emotional Well-Being and Language Beliefs in Heritage Bilingual Families
by Paola Bonifacci, Claudia Borghetti and Martina Cangelosi
Eur. J. Investig. Health Psychol. Educ. 2024, 14(9), 2509-2522; https://doi.org/10.3390/ejihpe14090166 - 5 Sep 2024
Viewed by 1232
Abstract
The present study aimed to examine how parents’ psychological characteristics and positive beliefs about multilingualism predict children’s emotional well-being in 51 multilingual families with an immigrant background. Parents were interviewed to assess their beliefs about multilingualism and completed a battery of questionnaires assessing [...] Read more.
The present study aimed to examine how parents’ psychological characteristics and positive beliefs about multilingualism predict children’s emotional well-being in 51 multilingual families with an immigrant background. Parents were interviewed to assess their beliefs about multilingualism and completed a battery of questionnaires assessing depression, anxiety, psychological distress, parental competence, quality of life, and acculturative stress. They also completed the Strengths and Difficulties Questionnaire (SDQ), which assessed their children’s socio-emotional and behavioral characteristics. The results from regression analyses showed that parents’ depressive symptoms were significant concurrent predictors of children’s conduct problems. In contrast, higher acculturation stress was associated with more emotional problems and better prosociality in children, although the stronger predictor for the latter variable was parents’ self-efficacy. Positive beliefs about bilingualism were not related to children’s well-being. The discussion highlights the importance of targeting parents’ depressive traits and acculturation stress as possible risk factors for children’s emotional and behavioral problems. Conversely, fostering parental self-efficacy may promote children’s prosociality. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
21 pages, 961 KiB  
Article
Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being
by Sílvia Ala, Francisco Ramos-Campos and Inês Carvalho Relva
Eur. J. Investig. Health Psychol. Educ. 2024, 14(8), 2262-2281; https://doi.org/10.3390/ejihpe14080151 - 5 Aug 2024
Viewed by 1402
Abstract
The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate [...] Read more.
The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
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10 pages, 265 KiB  
Article
Trauma Exposure, Social Support and Mental Health in the General Population in Belgium
by Emilie Muysewinkel, Lara Vesentini, Helena Van Deynse, Lydia Gisle, Pierre Smith, Helena Bruggeman, Johan Bilsen and Roel Van Overmeire
Eur. J. Investig. Health Psychol. Educ. 2024, 14(7), 2047-2056; https://doi.org/10.3390/ejihpe14070136 - 15 Jul 2024
Viewed by 791
Abstract
Introduction: International research has shown that trauma exposure can lead to mental health disorders and affect social support. However, there is little insight into trauma exposure and its related issues in the general population of Belgium. Methods: Secondary cross-sectional data on the general [...] Read more.
Introduction: International research has shown that trauma exposure can lead to mental health disorders and affect social support. However, there is little insight into trauma exposure and its related issues in the general population of Belgium. Methods: Secondary cross-sectional data on the general adult population were retrieved from the Belgian Health Interview Survey. Using a representative sample, data were collected on trauma exposure in the past 12 months, and the disclosure of trauma, social support, depressive/anxiety symptoms and background factors were investigated. Results: In total, 7728 participants were included in this study, and 4.8% (N = 369) reported trauma exposure within the past 12 months. People with trauma exposure (4.8%, N = 369) consistently had more anxiety and depressive symptoms than those without trauma (p < 0.001), and people with multiple trauma exposures had more symptoms than those with a single trauma (p < 0.001). Social support was observed to be lower among those with trauma exposure (p < 0.001), and 17.1% had never disclosed their trauma to anyone. Sexual violence was higher among women (64.5%) and was also the least disclosed form of trauma. Conclusions: Trauma exposure is associated with poorer mental health in Belgium. Around a fifth of those who experience trauma do not disclose their trauma, which is the most common after sexual violence. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
15 pages, 918 KiB  
Article
Network Analysis of the Association between Minority Stress and Activism in LGB People from Poland
by Aleksandra Krok, Zofia Kardasz and Aleksandra M. Rogowska
Eur. J. Investig. Health Psychol. Educ. 2024, 14(7), 1853-1867; https://doi.org/10.3390/ejihpe14070122 - 21 Jun 2024
Cited by 1 | Viewed by 1109
Abstract
(1) Background: This paper presents an analysis of the associations between minority stressors and activism in the population of lesbian, gay, and bisexual individuals in Poland. (2) Methods: The cross-sectional online-based research was conducted among 192 lesbian, gay, and bisexual (LGB) people in [...] Read more.
(1) Background: This paper presents an analysis of the associations between minority stressors and activism in the population of lesbian, gay, and bisexual individuals in Poland. (2) Methods: The cross-sectional online-based research was conducted among 192 lesbian, gay, and bisexual (LGB) people in two groups: activists (n = 51) and people not engaged in activism (n = 141). Four scales of the Sexual Minority Stress Scale were used: Internalized Homophobia, Expectation of Rejection, Concealment, and Sexual Minority Negative Events Scale. Activism was measured using the Activism Scale and a single item asking about belonging to an activist group. (3) Results: Activists, lesbians, and gays scored significantly higher in the Sexual Minority Negative Events than people not involved in activism and bisexual individuals. Attitude toward LGBT+ activism correlated weakly and positively with Sexual Minority Negative Events and Expectation of Rejection while negatively with Internalized Homophobia. The Network Analysis showed that positive attitudes toward LGBT+ activism, the expectation of rejection, and negative events in minority stress are the most influential variables in the network model, playing a crucial role in the interaction between particular dimensions of minority stress. (4) Conclusions: Prevention and intervention programs should focus on reducing minority stress, especially negative events and rejection, especially among lesbians, gays, and people engaged in LGBT+ activism. The cooperation of politicians, lawyers, social workers, and psychologists is required to decrease homophobia and the stigmatization of people representing sexual and gender minorities. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
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12 pages, 321 KiB  
Article
Associations between Stigma, Depression, and Adherence to Antiretroviral Therapy in Brazilian Men Who Have Sex with Men Living with HIV
by Felipe Alckmin-Carvalho, Henrique Pereira, António Oliveira and Lucia Nichiata
Eur. J. Investig. Health Psychol. Educ. 2024, 14(6), 1489-1500; https://doi.org/10.3390/ejihpe14060098 - 23 May 2024
Cited by 1 | Viewed by 1096
Abstract
Adherence to antiretroviral therapy (ART) is a complex and multi-determined process that is influenced by psychosocial variables. Although international studies have pointed to the adverse impact of HIV stigma, sexual stigma, and depression on ART adherence among men who have sex with men [...] Read more.
Adherence to antiretroviral therapy (ART) is a complex and multi-determined process that is influenced by psychosocial variables. Although international studies have pointed to the adverse impact of HIV stigma, sexual stigma, and depression on ART adherence among men who have sex with men (MSM) with HIV, less is known about this association among Brazilians. We aimed to (a) evaluate indicators of depression, stigma related to HIV and homosexuality, and adherence to ART in a sample of Brazilian MSM living with HIV; (b) assess possible correlations between the variables analyzed, and (c) assess the impact of HIV and sexual stigma and depression on ART adherence. This cross-sectional study comprised 138 Brazilian MSM living with HIV as participants. Scales used included: a sociodemographic/clinical questionnaire, the questionnaire for assessment of adherence to antiretroviral therapy (CEAT-HIV), the Beck depression inventory (BDI-II), the internalized homophobia scale, and the HIV stigmatization scale. The mean adherence score was relatively high (78.83, within a range of 17–89 points). However, we observed inadequate ART adherence (CEAT-HIV < 75) in 28 (20.2%) respondents. Participants reported high scores for internalized sexual stigma, perceived sexual stigma in the community, and HIV stigma. Symptoms of depression were identified in 48.47% of participants. We found negative correlations between depression, HIV stigma, and treatment adherence, but not between sexual stigma and ART adherence. HIV-related stigma and sexual stigma were positively correlated with depression. Our regression analysis indicated that each year of age at diagnosis of HIV increased adherence by 0.22 points, on average. Each additional BDI-II score reduced adherence to ART by 0.20 points. The high prevalence of depression, HIV stigma, and sexual stigma, and their adverse effects on ART adherence and mental health, point to the need to implement evidence-based interventions to reduce sexual and serological stigma in the general population, as well as to mitigate the negative impacts of stigma on MSM living in HIV in Brazil. They also highlight the importance of periodically screening for these variables among MSM treated in Brazilian public health services, especially among those with inadequate adherence to ART. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
18 pages, 324 KiB  
Article
“It’s a Lot of Closets to Come Out of in This Life”: Experiences of Brazilian Gay Men Living with Human Immunodeficiency Virus at the Time of Diagnosis and Its Biopsychosocial Impacts
by Felipe Alckmin-Carvalho, Henrique Pereira and Lucia Nichiata
Eur. J. Investig. Health Psychol. Educ. 2024, 14(4), 1068-1085; https://doi.org/10.3390/ejihpe14040070 - 19 Apr 2024
Cited by 2 | Viewed by 1588
Abstract
We investigated the experiences of Brazilian gay men with HIV, focusing on the moment of diagnosis and its potential biopsychosocial impacts. This clinical–qualitative study involved 15 participants interviewed online and synchronously by a clinical psychologist in 2021. Thematic analysis was employed to analyze [...] Read more.
We investigated the experiences of Brazilian gay men with HIV, focusing on the moment of diagnosis and its potential biopsychosocial impacts. This clinical–qualitative study involved 15 participants interviewed online and synchronously by a clinical psychologist in 2021. Thematic analysis was employed to analyze the data. Interpretations were grounded in Minority Stress Theory. Four thematic axes emerged, including “Diagnostic Revelation”, “Social and Internalized Stigma”, “Biopsychosocial Effects of Living with HIV”, and “Gratitude for Treatment Advances and the Brazilian Health System”. The diagnosis was often experienced as traumatic, exacerbated by the absence of empathy and emotional support from healthcare providers. Participants commonly reported guilt, fear upon learning of their HIV status, social isolation, loneliness, lack of social support, and damage to affective-sexual relationships. Many also noted a decline in mental health, even those without HIV-related medical complications. Despite over 40 years since the HIV epidemic began, the prevalence of homophobia and serophobia among gay men remains widespread, including within the multidisciplinary teams of specialized services. This indicates that the stigma associated with homosexuality and HIV persists, despite significant biomedical progress in the diagnosis and treatment of the infection, particularly in Brazil. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
11 pages, 644 KiB  
Article
Emotional Exhaustion Scale (ECE): Psychometric Properties in a Sample of Portuguese University Students
by Sílvia Ala, Francisco Ramos Campos and Inês Carvalho Relva
Eur. J. Investig. Health Psychol. Educ. 2024, 14(4), 1044-1054; https://doi.org/10.3390/ejihpe14040068 - 17 Apr 2024
Cited by 2 | Viewed by 2080
Abstract
Academic emotional exhaustion is the first stage of academic burnout syndrome, and it is necessary to assess it and intervene early, as the consequences can lead to harmful effects on psychological well-being. The main objectives of this study were to explore the psychometric [...] Read more.
Academic emotional exhaustion is the first stage of academic burnout syndrome, and it is necessary to assess it and intervene early, as the consequences can lead to harmful effects on psychological well-being. The main objectives of this study were to explore the psychometric properties of the Emotional Exhaustion Scale (ECE); to assess the association with suffering and positive well-being, using the MHI-5 Inventory; and to provide information on its validity and to compare it with these constructs. A total sample of 526 university students (81% female and 19% male) aged between 17 and 62 (M = 21.42 years and SD = 5.78) took part in this study. Exploratory and confirmatory factor analyses were carried out. In the internal consistency assessment, the ECE was 0.89 and the MHI-5 was 0.81 (Cronbach’s alpha). Exploratory factor analysis was carried out with Varimax rotation and confirmatory analysis, obtaining the factor that explains 50.5% of the variance. The results indicated that the ECE has adequate psychometric properties for use with higher education students in Portugal. Its use by mental health professionals in higher education institutions could be very relevant for screening for emotional exhaustion and thus preventing possible serious pathologies. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
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21 pages, 1536 KiB  
Article
Cultural Divergence in Psychedelic Use among Medical Students: An ESPAD-Adapted Survey among Poles and Iraqis
by Ahmed Al-Imam, Marek A. Motyka and Michal Michalak
Eur. J. Investig. Health Psychol. Educ. 2024, 14(3), 563-583; https://doi.org/10.3390/ejihpe14030038 - 5 Mar 2024
Viewed by 1332
Abstract
Psychedelics can profoundly alter cognition and consciousness. Their use in Middle Eastern countries, including Iraq, is ambiguous. We aim to investigate psychedelic awareness and use among Iraqi and Polish medical students. We surveyed 739 university students from Poland (315) and Iraq (424) using [...] Read more.
Psychedelics can profoundly alter cognition and consciousness. Their use in Middle Eastern countries, including Iraq, is ambiguous. We aim to investigate psychedelic awareness and use among Iraqi and Polish medical students. We surveyed 739 university students from Poland (315) and Iraq (424) using 31 adapted questions from the European School Survey Project on Alcohol and Other Drugs (ESPAD). We conducted multivariable analyses based on binary logistic regression to identify the factors associated with psychedelic awareness and use. Most of the respondents were females (65.6%) and senior medical students (69.6%). Notably, the Polish students displayed a higher prevalence of psychedelic use (21.6% compared to 1.2%, p < 0.001), while the Iraqi participants exhibited a lower familiarity with psychedelics (p < 0.001). The multivariable model demonstrated a commendable level of statistical accuracy and satisfactorily conformed to the Hosmer–Lemeshow goodness-of-fit test (statistical accuracy = 91.61%, Nagelkerke R2 = 0.488, p-value = 0.848). Several factors emerged as correlates of increased psychedelic use, including lacking an intact religious belief system or commitment to its practice (OR = 7.26, 95% CI [2.33, 22.60]). Additionally, those who perceived a low risk associated with sporadic psychedelic use (3.03, [1.44, 6.36]) were likelier to engage in such behavior. Other factors included residing in Poland (2.82, [0.83, 9.55]), maintaining positive attitudes toward psychedelics (2.49, [1.20, 5.14]), frequent social nightlife activities (2.41, [1.26, 4.61]), male gender (2.05, [1.10, 3.85]), and cigarette or tobacco smoking (2.03, [1.06, 3.86]). Significant disparities exist between Poles and Iraqis, influenced by religiosity, perceptions of the usage risks, geographical location, gender, attitudes toward psychedelics, parental leniency, and social freedom, especially concerning nightlife activities. Addressing the factors influencing psychedelic usage is paramount to responsible psychedelic engagement and culturally sensitive interventions to prevent misuse. Full article
(This article belongs to the Special Issue Disparities in Mental Health and Well-Being)
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