Study finds ethnic disparities in access to early psychological interventions for psychosis in England

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A new study led by UCL researchers has found that people experiencing a psychotic episode for the first time are less likely to receive early psychiatric intervention in England if they are from an ethnic minority background.

Some groups were only half as likely to receive early treatment, which is critical for improving outcomes later in life for people with mental illnesses such as schizophrenia, according to published results. Psychiatric Research and the National Institute for Health and Care Research (NIHR) led by UCL’s Mental Health Policy Research Unit.

Early intervention is very important for people with psychosis, as early treatment can improve long-term prognosis. Offering early intervention, including treatments known to be effective, such as cognitive behavioral therapy and family intervention, to everyone who needs it is now a policy-directed goal in England.

Unfortunately, we found that there are stark, widespread racial disparities in who receives these early interventions for psychosis, both talk therapy and family interventions.”

Merle Schleiff, lead author, PhD candidate, UCL Psychiatry

Researchers reviewed three years of data from the National Clinical Audit of Psychosis, commissioned by the Healthcare Quality Improvement Partnership, which included data on 29,610 people with first-episode psychosis who contacted early intervention psychosis services in England. They were reviewing whether people were offered, and whether they received, two main non-pharmacological treatments for early psychosis: tailored talk therapy – cognitive behavioral therapy for psychosis (CBTp) – and family interventions, which help families help people with psychosis. by doing .

They found that across all ethnic groups, only 47% of people experiencing a first episode of psychosis in the study received CBTp and only 21% received family intervention.

Almost all ethnic minority groups were less likely to receive CBTp than white British patients. Among South Asians, Chinese and blacks, white Britons were about half as likely to have received CBTP, while Bangladeshis were the least likely to have received CBTP. Certain ethnic groups, particularly black adults, were also less likely to receive family intervention services.

Although the study did not investigate the reasons for the disparity, the study authors said there are likely multiple factors for services and staff, such as the lack of treatment suitability or interpreters, as well as under-recruitment of some groups of service users. With mental health services or perceived treatments that are not tailored to their own needs for their limited relevance. Some ethnic groups may experience cooperative pathways to care such as involuntary hospitalization, which may reduce trust in health care professionals and services.

Professor Sonia Johnson (UCL Psychiatry), director of the Mental Health Policy Research Unit, said: “Despite a national service model intended to ensure effective treatment is offered to all, many people still miss out on much-needed early treatment for mental illness.

“Mental health care providers need to be aware of and culturally sensitive to such disparities between ethnic groups. More research is needed to better understand the complex factors behind such disparities and the best ways to address them, ideally involving service users themselves. Ensuring that treatments helpful and relevant to the entire population.”


Journal Reference:

Schliff, M., etc. (2023). Ethnic differences in receipt of psychological intervention in early intervention psychosis services in England – a cross-sectional study. Psychiatric Research.

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