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

People experiencing a psychotic episode for the primary time are less more likely to receive early psychological interventions in England in the event that they are from an ethnic minority background, finds a brand new study led by UCL researchers.

Some groups were only half as more likely to receive early treatment, which is essential for improving outcomes later in life for individuals with psychotic disorders similar to schizophrenia, in line with the findings published in Psychiatry Research and led by the National Institute for Health and Care Research (NIHR) Mental Health Policy Research Unit at UCL.

Early intervention may be very necessary for individuals with psychosis, as treatment early on can greatly improve the long-term prognosis. Offering early intervention, including treatments which are known to be effective similar to Cognitive Behavioural Therapy and family interventions, to everyone who needs it’s now a policy-mandated goal in England.

Unfortunately, we found there are stark, pervasive ethnic inequalities in who gets these early interventions for psychosis, each for talk therapy and for family interventions.”

Merle Schlief, Lead Writer, PhD Candidate, UCL Psychiatry

The researchers reviewed three years of information from the National Clinical Audit of Psychosis, commissioned by the Healthcare Quality Improvement Partnership, including data on 29,610 individuals with first-episode psychosis who were in touch with Early Intervention in Psychosis services in England. They were reviewing whether people were offered, and whether or not they received, two of the important thing non-pharmacological treatments for early psychosis: tailored talk therapy – Cognitive Behavioural Therapy for psychosis (CBTp) – and family interventions, which support families in helping individuals with psychosis.

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

Nearly all ethnic minority groups were less more likely to receive CBTp in comparison with white British patients. South Asian, Chinese and Black people were near half as likely as white British people to receive CBTp, with Bangladeshi people being the least more likely to receive CBTp. Some ethnic groups, particularly Black adults, were also less more likely to receive family intervention services.

While this research didn’t investigate causes of the disparities, the study authors say there are likely multiple aspects on the service and staff side, similar to misperceptions of appropriateness of treatments or lack of interpreters, in addition to service users from some groups being less engaged with mental health services or perceiving treatments which have not been tailored to their very own needs as of limited relevance to them. Some ethnic groups usually tend to experience coercive pathways to care similar to involuntary hospital admissions, which might reduce trust of healthcare professionals and services.

Professor Sonia Johnson (UCL Psychiatry), Director of the Mental Health Policy Research Unit, said: “Despite a national service model intended to make sure all are offered effective treatment, many persons are still missing out on much-needed early treatment for psychosis.

“Mental health care providers need to pay attention to such disparities between ethnic groups and be culturally sensitive. More research can be needed, ideally involving service users themselves, to higher understand the complex reasons behind such disparities and the perfect ways to handle them, including ensuring that treatments are helpful and relevant across the entire population.”