Social determinants of youth with mild intellectual disability in outpatient care for mental health disorders: a case–control study

This study examined the unique role of multiple social determinants of mental health (SDOMH) associated with mental health disorders (MHD) for children with mild intellectual disability (MID), advancing understanding in a fragmented research area. Using a population-based case-control study design, four groups aged 0-17 years (M_age = 10.6, 35.6% female) were studied: children receiving outpatient mental health care for MHD with MID (n = 505) and without MID (n = 2767), each with a matched control group from the general population (n = 2525 and n = 13,835, respectively). Through multivariate logistic regression analyses, both MHD groups were compared to their control group and each other to examine the likelihood of a SDOMH associated with receiving mental health care for MHD in children with and without MID. Children with MID receiving mental health care showed significant differences in multiple domains compared to their control group and to children receiving mental health care without MID. They were less likely to have European-born mothers, more likely to have parents with moderate or low education levels, and tended to live in smaller, single-parent, lower-income households. Similar, though less deviant, patterns were observed for children receiving mental health care without MID compared to the general population, except for parental education. Our study highlights that SDOMH are associated with the likelihood of receiving care for MHD in children. Moreover, children with MID face disproportionate disadvantages, particularly regarding low parental education and household income. Thus, interventions should not only target the child but also their family and environmental context.