Cumulative experiences of discrimination among people experiencing homelessness in Madrid (Spain): Intersectionality and mental health correlates.

The study aims to characterize individuals experiencing homelessness in Madrid (Spain) who report the highest levels of discrimination across various settings, with a focus on intersectional vulnerabilities and the relationship between these experiences and their mental health status. Structured interviews were conducted with 355 people experiencing homelessness, including questions about their experiences of discrimination across institutional and everyday settings throughout their lifetime. At least one in every two participants reported thefts and property damage, unfair treatment by law enforcement, and unprovoked threats and assaults. Nearly one-third of the individuals interviewed also reported unfairly the loss of a close relationship and unfair treatment in the labor market, the housing market, and public transportation and commercial establishments. The quartile that reported suffering the highest levels of discrimination consistently across contexts was younger on average and characterized by a greater presence of women and Spanish-born individuals. Their history of homelessness was more complex, with a higher proportion of youth-onset homelessness and unsheltered homelessness, and greater involvement in prostitution and survival sex. Moreover, individuals who reported more experiences of discrimination showed a higher prevalence of disabilities and mental health diagnoses, as well as substance abuse, anxiety and depressive symptoms, and symptomatology consistent with the diagnosis of complex posttraumatic stress disorder. The cumulative impact of experiences of discrimination and intersectional vulnerabilities highlights the need for targeted interventions and tailored attention in different services and institutions, recognizing all the potential psychosocial determinants of mental health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).