Health UK (Commonwealth Union) – A recent study led by University College London (UCL) researchers reveals that individuals from ethnic minority backgrounds who are experiencing their first psychotic episode in England are less likely to receive timely psychological interventions. The findings indicate that certain ethnic groups were only half as likely to access early treatment, which is a critical factor in enhancing long-term outcomes for individuals with conditions like schizophrenia and other psychotic disorders. This research, published in Psychiatry Research, was conducted in collaboration with the National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit at UCL.
The primary author of the study, Merle Schlief, who is pursuing a PhD in UCL Psychiatry, indicated that early intervention holds significant importance for individuals dealing with psychosis, as timely treatment can substantially enhance long-term outcomes. Providing early intervention, which encompasses established treatments like Cognitive Behavioral Therapy and family interventions, to all those in need is a mandated policy objective in England.
“Unfortunately, we found there are stark, pervasive ethnic inequalities in who gets these early interventions for psychosis, both for talk therapy and for family interventions.”
The researchers conducted an analysis of three years’ worth of data from the National Clinical Audit of Psychosis, which was commissioned by the Healthcare Quality Improvement Partnership. This dataset encompassed information about 29,610 individuals who had experienced their initial episode of psychosis and had come into contact with Early Intervention in Psychosis services in England. The primary focus of this review was to ascertain whether individuals were presented with, and subsequently received, two crucial non-pharmacological treatments for early-stage psychosis: customized talk therapy, specifically Cognitive Behavioral Therapy for psychosis (CBTp), and family interventions designed to aid families in supporting those with psychosis.
The study unveiled that, irrespective of their ethnic background, only 47% of the participants who had their first episode of psychosis in the study received CBTp, while merely 21% received family intervention.
Furthermore, individuals from almost all ethnic minority groups were less likely to receive CBTp when compared to their white British counterparts. South Asian, Chinese, and Black individuals were nearly half as likely as white British individuals to access CBTp, with Bangladeshi individuals having the lowest likelihood of receiving this therapy. Certain ethnic groups, particularly Black adults, were also less likely to avail themselves of family intervention services.
It is important to note that this research did not delve into the root causes of these disparities. However, the study authors suggested that there might be multiple factors at play on the service and staff side, such as misconceptions regarding the appropriateness of treatments or a shortage of interpreters. Additionally, it is possible that individuals from certain groups may be less engaged with mental health services or perceive treatments that are not tailored to their specific needs as having limited relevance. Some ethnic groups are more likely to experience coercive pathways to care, such as involuntary hospital admissions, which can erode trust in healthcare professionals and services.
Professor Sonia Johnson of UCL Psychiatry, who serves as the Director of the Mental Health Policy Research Unit indicated the the findings, highlighting that despite the existence of a national service model aimed at ensuring that everyone is offered effective treatment, many individuals are still missing out on essential early treatment for psychosis.
“Mental health care providers need to be aware of such disparities between ethnic groups and be culturally sensitive. More research is also needed, ideally involving service users themselves, to better understand the complex reasons behind such disparities and the best ways to address them, including making sure that treatments are helpful and relevant across the whole population.”
