Psychological Therapy in Secondary Mental Health Care: Access and Outcomes by Ethnic Group
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To explore the differences in access to, and outcomes of, psychological therapy for different ethnic groups across a South London Mental Health Trust.
This study used Trust data to explore the proportions of ethnic groups accessing psychological therapy as a proportion of all patients supported by the Trust, as well as their outcomes within broad diagnostic clusters.
Compared to proportions in the local population, there were significantly more White/White British patients and significantly fewer patients from ‘other ethnic groups’ in the Trust (p < .05). There was also significantly greater proportion of Black/Black British patients with schizophrenia diagnoses compared to the proportion of Black/Black British people in the local population (p < .001). Of those accessing psychological therapy, there were significantly more White/White British and ‘other ethnic group’ patients and significantly fewer Black/Black British patients (p < .05). For schizophrenia diagnoses, significantly fewer Black/Black British and ‘other ethnic group’ patients were accessing psychological therapy (p < .05); however for behavioural and emotional disorders, there were significantly higher proportions of ‘other ethnic group’ and White/White British patients. Outcomes varied by diagnosis; Black/Black British patients experienced significantly higher distress scores at the beginning of therapy for depression and neurotic diagnoses (p < .05), with the latter persisting at the end of treatment.
Across the Trust, there were significant differences in the proportion of ethnic groups in accessing psychological therapy, as well as in outcomes. More research is needed to understand the factors that may underlie these disparities.
KeywordsEthnicity Psychological therapy Access Outcomes CORE-OM
The views expressed in this article are those of the author(s) and not necessarily those of the South London and Maudsley NHS Foundation Trust.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflicts of interest.
Research Involving Human Participants and/or Animals
Ethical approval was obtained from the research and development committee within the organisation to conduct this research. The Ethical standards of the 1964 Helsinki Declaration and its following amendments or comparable ethical standards were followed.
Informed consent was not required for this study.
- 1.McManus S, Meltzer H, Brugha T, Bebbington P, Jenkins R. Adult psychiatric morbidity in England, 2007: results of a household survey. The Health and Social Care Information Centre, Social Care Statistics. 2009. Retrieved from http://content.digital.nhs.uk/catalogue/PUB02931/adul-psyc-morb-res-hou-sur-eng-2007-rep.pdf. Accessed 30 June 2018.
- 2.Department of Public Health, London Borough of Lambeth. Public health report for Lambeth: director of public health annual report 2013–14. 2015. Retrieved from https://www.lambeth.gov.uk/sites/default/files/ssh-lambeth-public-health-report-2014.pdf. Accessed 30 June 2018.
- 3.Eligon R, Bibbings S. Lambeth research and consultation briefing: equalities insight. 2013. Retrieved from https://www.lambeth.gov.uk/sites/default/files/Lambeth%2520Equalities%2520Insight%2520Summary%2520%25202013%5B1%5D.pdf. Accessed 30 June 2018.
- 8.Care Quality Commission. Count me in census 2010. London: CQC; 2011.Google Scholar
- 9.Fountain J, Hicks J. Delivering race equality in mental health care: report on the findings and outcomes of the community engagement programme 2005–2008. 2010. University of Lancaster: ISCRI.Google Scholar
- 10.Brown JS, Ferner H, Wingrove J, Aschan L, Hatch SL, Hotopf M. How equitable are psychological therapy services in South East London now? A comparison of referrals to a new psychological therapy service with participants in a psychiatric morbidity survey in the same London borough. Soc Psychiatry Psychiatr Epidemiol. 2014;49(12):1893–902. https://doi.org/10.1007/s00127-014-0900-6.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.South London and Maudsley NHS Foundation Trust. Referral guidance. Retrieved from: https://www.national.slam.nhs.uk/referrals/. Accessed 1 Oct 2018.
- 13.World Health Organization. International statistical classification of diseases and related health problems. 5th ed. Geneva: World Health Organization; 2016.Google Scholar
- 15.Office for National Statistics. Ethnic groups by gender, borough [Data file]. 2015. Retrieved from https://data.london.gov.uk/dataset/ethnic-groups-borough. Accessed 30 June 2018.
- 23.NHS Digital. Outcomes for treatment for anxiety and depression. 2018. Retrieved from https://www.ethnicity-facts-figures.service.gov.uk/health/patient-outcomes/outcomes-for-treatment-for-anxiety-and-depression/latest. Accessed 30 June 2018.
- 25.Sashidharan SP. Inside outside: improving mental health services for black and minority ethnic communities in England. London: Department of Health; 2003.Google Scholar
- 32.Department of Health. Delivering race equality: a framework for action.Google Scholar
- 37.Mays VM, Jones AL, Cochran SD, Taylor RJ, Rafferty J, Jackson JS. Chronicity and mental health service utilization for anxiety, mood, and substance use disorders among black men in the United States; ethnicity and nativity differences. InHealthcare. 2018;6(2):53 Multidisciplinary Digital Publishing Institute.CrossRefGoogle Scholar
- 40.Sue S, Zane N, Young K. Race and ethnicity in psychotherapy research. In: Bergin AE, Garfield SL, editors. Handbook of psychotherapy and behavior change. New York: Wiley; 1994. p. 783–830.Google Scholar
- 42.Trust for London. Poverty and inequality indicators. Retrieved from: https://www.trustforlondon.org.uk/data/boroughs/lambeth-poverty-and-inequality-indicators/. Accessed 30 June 2018.