Structural forces are the intersecting systems of power that co-constitute each other to create matrices of privilege and oppression that influence access to opportunities and resources, including professional mental health care (Buchanan & Wicklund, 2020). There is extensive documentation of how racism (Adams et al., 2022), nativism (Pérez & Fortuna, 2005), cissexism (Brown et al., 2015), heterosexism (Spengler et al., 2023), ableism (including stigma of mental illness; Brenner et al., 2022; Kattari, 2020), religious discrimination (Samari et al., 2018), classism (Choi & Miller, 2018), ageism (Robb et al., 2002), and other structural forces function in concert to deny access to quality mental health care for members of stigmatized or marginalized groups, particularly those who hold multiple marginalized identities (Taylor & Richards, 2019).

For more details about this help-seeking determinant, please read Hammer and colleagues (2024), from which a portion of the information about this construct is excerpted.

A description of available structural forces measures can be found on the Structural Forces Measures page.