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

This study examined the unique role of diverse social determinants of mental health (SDOMH) associated with mental health problems (MHP) for children with mild intellectual disability (MID), compared to peers with and without MHP. This population-based case-control study included four groups aged 0–17 years ( M _age = 10.6, 35.6% female). Two groups of children receiving outpatient mental health care for MHP with MID ( n  = 505) and without MID ( n  = 2,767), each with a matched control group from the general population ( n  = 2,525 and n  = 13,835, respectively), were studied. Through multivariate logistic regression analyses, both MHP groups were compared to their control group and each other to examine the likelihood of a SDOMH associated with receiving mental health care for MHP 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 without MID receiving mental health care compared to the general population, except for parental education. Our study highlights that diverse SDOMH are associated with the likelihood of receiving care for MHP 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.