This chapter examines the ways in which people with mental health conditions who also belong to other excluded groups may be particularly disadvantaged, in general and by mental health services. People with mental health conditions are at risk of social exclusion, but many from certain social identity groups are particularly at risk: for example, women, people from black and minority ethnic groups, and those from sexual minorities. In addition, certain groups of people are defined by their exclusion from society, such as refugees and asylum seekers, prisoners, and the homeless. The occurrence of mental health conditions in these groups is much higher than in the general population and they will often face barriers to accessing essential material resources and adequate healthcare. The presence of mental health conditions and group characteristics intersect to exacerbate the degree of exclusion experienced by the people in these groups. Some combinations may result in particularly profound states of deprivation and destitution. These severe and multiple forms of exclusion have been named ‘deep social exclusion’ or ‘people with multiple and complex needs’, two examples of which are seen in ‘multiple exclusion homelessness’ and people with multiple diagnoses.