Public perspectives on structural inequalities and their public mental health impact

A wooden sign against the sky. Black text on the sign reads 'Amplify your voice' with an arrow pointing down
Photo by Kelly Lacy

What is this study and why is it important?

Structural and systematic inequalities are understood as societal factors that advantage one group and marginalise another such as racism and discrimination, lack of financial resources, unequal access to good housing and healthcare, and other forms of exclusion. We know that people experience structural and systemic inequalities and we know that these inequalities impact public mental health. A growing number of studies are addressing this.

What is less well understood is how people experience inequalities, in their own view and in their own words; what experiencing various forms of inequalities means in people’s day-to-day lives in terms of their mental health, how it affects them and their communities, and what their priorities for change are. Working in two different sites, collecting data through qualitative interviews and using Photovoice, we aim to answer the following question: How do people experience structural inequalities and how do these affect their mental health? Photovoice is an approach that encourages people to reflect on experience and use photos, videos, art, writing or other creative methods to ‘voice’ their feelings and convey their understanding, as the example below shows.

‘A Diary of Scent’ by Gillian Samuel, COVID Life Project at

Through the use of art, photography and creative writing, Gillian was able to find her voice to reflect on the experience of lockdown. Such methods can be adopted using Photovoice to explore and express thoughts around structural inequalities

What is the context of this research?

This study is one of several projects conducted as part of the Public Mental Health Programme of the NIHR School for Public Health Research. The Public Mental Health Programme is concerned with mental health at the population level, and aims to answer questions such as: What does a mentally healthy population look like? What determines this? How do we improve outcomes? Where should we focus our efforts?

How are McPin and people affected by mental health problems involved?

A team of Peer Researchers based at McPin has been working on the Public Mental Health Programme for 2 years. The team contributes to all research projects on the programme and leads on this study into how people experience structural and systemic inequalities. Previous work has involved the facilitation of public involvement workshops, reviewing key research literature and shaping the discussion and planning across many areas of the programme.

What is the current status of the project?

We are at the initial phase of the study: writing the protocol and getting ready for data collection.

Where can I find more information?

You can find out more about the Public Mental Health Programme here and our team here. You can contact Gillian for more information at