Difference and intersectionality in children and young People’s mental health services

This special section contains ten articles from authors who responded to our invitation to share their research, experiences, and views on the theme of difference and intersectionality (Crenshaw, 2017) in children and young people’s mental health services. When deciding the scope for this special section, we faced the dilemma of how broadly to cast the net in making this invitation. In times where there are so clearly groups of individuals who face greater oppression and disadvantage, it feels important to ensure that their experiences are centred and that space for completing meaningful reflection on addressing inequalities for these groups is not diluted. However, we also turned toward how considering diversity broadly might allow space for often-overlooked areas of difference, promoting a more holistic and nuanced understanding of how various forms of inequality intersect and compound one another, and reveal unique challenges, synergies, and strategies for making meaningful change for people across diverse groups. We hope that by keeping this broad focus, we have enabled authors to bring areas of diversity that are often less discussed.

As papers started to arrive for review, we were struck by the different ways that the theme of diversity and intersectionality had resonated with authors. The papers covered a broad range of themes from reviews of existing literature to inform practice recommendations, to empirical research papers exploring the experiences of people from diverse backgrounds, to personal accounts from professionals reflecting on their own experiences working in health services. We also include celebrations of work being completed to address inequalities and better respond to the needs of those from diverse communities, such as an update on the Rainbow Project, being run at University College London Hospital (UCLH). While we received papers on a number of the Social GGRRAAACCEEESSS (Gender, Geography, Race, Religion, Age, Ability, Appearance, Culture, Class/caste, Education, Employment, Ethnicity, Spirituality, Sexuality, Sexual orientation; Burnham, 2012) it was also notable that some such as religion, spirituality, employment, and appearance, were not explicitly in focus for any of the articles.

As two psychologists working in a paediatric psychology service in central London, we often find ourselves reflecting on diversity and difference within the population we serve and considering how we adapt our approach to different needs. We are fortunate to be surrounded by a large team of psychology colleagues who are enthusiastic about participating in discussing and reflecting on how we can do better. This has led to some action in an attempt to respond to calls to action such as Wood and Patel’s (2019) challenge that being nice is not enough and collective action to address racism in mental health services is urgently needed, as well as calls from our LGBTQ + patients to be louder in our allyship (Huckridge et al., 2021). Our team have published some of these efforts in an attempt to contribute to wider discussion (e.g. Pulham et al., 2019) and developed some specific interventions for minority populations (McParland & Huckridge, 2024). However, we often find ourselves stuck in a pattern where in pivotal moments such as the murder of George Floyd, the Group of Trainers in Clinical Psychology (2019) conference in Liverpool (Independent, 2019), and the current genocide occurring in Palestine, we become activated and committed to create space for doing the work to make improvements, but these spaces often shrink as the day-to-day work in often under resourced NHS teams intensifies. Editing this special section has encouraged us to reflect on this process and how we can remain accountable and committed to making progress in this area.

Many institutions have also created Equality, Diversity and Inclusion (EDI) roles with the intention of addressing inequalities. Ahsan (2022) argues that such roles are often ineffective, prioritising superficial diversity goals over meaningful structural change. They note that despite the efforts of EDI leads, they face institutional resistance, limited terms, and have minimal influence, lacking true support and resources for systemic change. The article calls for sustained funding, collective responsibility, and compassionate systems to move beyond performative acts and toward lasting transformation. Our team has also been influenced by the work of Vikki Reynolds, particularly her paper on “Leaning In” as Imperfect Allies (Reynolds, 2013), which suggests we:

• Use “Leaning in” as a way of inviting collective accountability while resisting righteousness and individualism. We find that if we share responsibility as a team we are more easily able to return to these discussions as they are not held with a single person (such as a team manager, or someone from a minority background).

We would recommend this paper for some further invitations for exploring this further.

As we conclude this editorial, we are reminded that the work of addressing difference and intersectionality in children and young people’s mental health services is ongoing and requires sustained commitment. The contributions within this issue highlight both the progress being made and the gaps that remain, encouraging further reflection, dialogue, and action. It is clear that meaningful change cannot rest solely on the shoulders of individuals in designated EDI roles, but must be embedded within collective responsibility across services, institutions, and policy-making. As editors, we are on our own journey with this theme too—continuously learning, questioning, and striving to do better both in our clinical practice and in the systems we are part of. A key reflection from this process has been the importance of sustaining engagement with these conversations, not just in moments of heightened awareness, but as an ongoing, embedded part of our work. As we navigate the complexities of systemic inequality, we must continue to ‘lean in’—embracing discomfort, fostering cultures of critique, and striving for imperfect but essential solidarity. We hope this collection of articles not only informs but also inspires practitioners, researchers, and policymakers to keep pushing for a more inclusive and equitable approach to mental health care for children and young people.