Stigmatised, marginalised, excluded: a multilevel investigation of migrant mental health disparities

This thesis investigates migrant mental health disparities through a multilevel lens informed
by the Social-Ecological Model (SEM). While migration is often associated with increased risks of depression, anxiety, and trauma-related disorders, these outcomes are shaped not only by individual vulnerabilities but also by social relationships, post-migration conditions, and structural barriers.
The thesis adopts a multi-method design comprising a secondary data analysis of European
populations, a scoping review of perinatal mental health among forced migrant women, a
policy review of UK resettlement frameworks for Afghan and Ukrainian forced migrants, and
an integrative discussion supported by a foundational chapter and a reflective chapter.
Together, these components provide a layered account of how stigma, marginalisation, and
exclusion operate at micro-, meso-, and macro-levels to shape migrant mental health.
The findings show that migrants experienced elevated risks of depression, with poorer
outcomes associated with factors such as poor health, socioeconomic disadvantage, limited
social support, and barriers to accessing care. Forced migrant women during the perinatal
period emerged as a particularly vulnerable subgroup, with elevated rates of depression,
anxiety, and post-traumatic stress disorder, alongside significant barriers to support. The
policy review further showed that differences in resettlement policy shaped post-migration
conditions relevant to mental health, including access to housing, healthcare, legal certainty, and social support.
By integrating these strands, the thesis offers a multilevel account of how migrant mental
health disparities are produced and sustained across different domains of life. It
demonstrates that migrant mental health cannot be addressed through clinical intervention
alone, but requires action across social, service, and policy contexts. The thesis concludes by offering evidence-based recommendations for more culturally sensitive care, targeted
support, improved data systems, and more equitable policy responses. Ultimately, it argues
that recognising migrants in health and social systems is essential for dismantling the
processes of stigma, marginalisation, and exclusion that underpin mental health inequalities.