Intersectionality, the study of how multiple social identities intersect and interact to shape individuals' experiences and inequalities, has gained recognition as a crucial framework for understanding various aspects of health, including mental health. This article highlights the gaps and limitations identified in a scoping review on intersectional inequalities in mental health, focusing on exploring understudied intersections and integrating quantitative and qualitative approaches. By addressing these gaps, we aim to pave the way for future research that can provide a more comprehensive understanding of intersectional mental health inequalities.

The scoping review analyzed 20 articles published between 2000 and 2019, focusing on the intersectional positions of race/ethnicity, gender, socioeconomic status, and sexual orientation. While the review provided valuable insights, it revealed several gaps and limitations that warrant further investigation.

The literature identified in the review predominantly focused on specific combinations of social positions, with some intersections receiving less attention. For instance, there was a dearth of studies exploring the intersection of sexual orientation and socioeconomic status, as well as meetings involving religion. These understudied intersections represent crucial gaps in our understanding of mental health inequalities. To address this, future research should prioritize exploring these neglected intersections to uncover unique challenges and disparities experienced by individuals with intersecting identities.

Analytical Approaches:

Analyzing intersectional inequalities requires careful consideration of appropriate analytical approaches. The review found that most studies estimated absolute excess intersectional disparities, while the joint intersectional inequality, which compares health outcomes between the doubly advantaged and doubly disadvantaged groups, was rarely explored. Future research should adopt diverse analytical approaches, including estimating absolute and relative inequalities. By employing various methods, researchers can capture different facets of intersectional disparities and provide a more nuanced understanding of their impact on mental health.

While the reviewed studies primarily employed quantitative methods, integrating qualitative approaches can enrich our understanding of the lived experiences behind intersectional mental health inequalities. Qualitative research allows a deeper exploration of the mechanisms and contextual factors contributing to these inequalities. By combining quantitative data analysis with qualitative insights, researchers will develop a more comprehensive understanding of the complexities and nuances associated with intersectional mental health disparities.

Future research on intersectional mental health inequalities should focus on several key areas to address the identified gaps and limitations.

Researchers should prioritize studying understudied intersections, such as sexual orientation and socioeconomic position, and intersections involving religion. By examining these intersections, we can better understand individuals with multiple marginalized identities' unique challenges and develop targeted interventions to address their mental health needs.

Future studies should adopt diverse analytical approaches, including measures of absolute and relative intersectional inequalities. This will provide a more comprehensive assessment of the magnitude and nature of mental health disparities across different intersectional positions, enabling more effective policy and intervention development.

Researchers should integrate qualitative research methods alongside quantitative analyses to gain full knowledge of the mechanisms underlying intersectional mental health inequalities. Qualitative approaches can shed light on the lived experiences, contextual factors, and social processes contributing to these inequalities, providing invaluable insights for designing culturally sensitive interventions and policies.

In conclusion, the scoping review on intersectional inequalities in mental health has highlighted the pressing need for further research and action to understand and address the unique challenges individuals face with intersecting social identities face. Furthermore, the findings underscore the importance of adopting an intersectional lens to comprehensively examine mental health disparities and develop targeted interventions for marginalized populations.

To advance our understanding of intersectional mental health, it is crucial to explore understudied intersections, such as sexual orientation and socioeconomic position. By including these intersections in research and analysis, we can uncover the barriers and factors contributing to mental health disparities among diverse communities in the United States. This knowledge will enable us to develop tailored interventions that address mental health's complex and intersecting social determinants.

In this context, Pre-Exposure Prophylaxis (PrEP) holds promise in promoting mental health equity. PrEP is a preventive medication that reduces the risk of acquiring HIV among individuals at high risk. Recognizing the intersectionality of sexual orientation and mental health, integrating PrEP into mental health care can have profound implications. By ensuring access to PrEP and providing comprehensive care, including mental health support, we can address the unique needs of individuals within LGBTQ+ communities who may face compounded marginalization and mental health challenges.

Moreover, PrEP programs can serve as an avenue for promoting mental health awareness, education, and destigmatization. By incorporating mental health screenings, support services, and counseling within PrEP initiatives, we can address the mental health needs of individuals in a holistic manner, fostering overall well-being and reducing mental health disparities within LGBTQ+ communities.

Collaboration between researchers, policymakers, healthcare providers, and community organizations is paramount to implementing effective strategies and interventions. This interdisciplinary approach can ensure that the insights gained from intersectional mental health research are translated into actionable policies and practices that promote mental health equity for all individuals, particularly those from marginalized backgrounds.

By acknowledging the complexities of intersectionality and integrating PrEP into mental health care, we can advance efforts to reduce mental health disparities and promote social justice to create an inclusive and equitable mental health landscape in the United States. Through continued research, advocacy, and community engagement, we can improve mental health outcomes and support the well-being of all individuals, regardless of their intersecting social identities.