Contextual determinants and participant perspectives on the common mental disorders and access to psychological treatments in UK ethnic minorities: Mixed methods study utilising data from the Adult Psychiatric Morbidity Surveys (APMS) (a CASE project with the National Centre for Social Research)
There are longstanding concerns in the UK that Black and Minority Ethnic people experience inequalities in access to mental health treatments. Black people are more likely to experience complex pathways into mental healthcare, with less contact with primary care and more experience of coercive pathways. Recently released data from the 2014 Adult Psychiatric Morbidity Survey (APMS), a nationally representative cross-sectional survey of individuals living in private households, indicated that Black respondents were less likely to receive treatments for Common Mental Disorders (CMD) than White British respondents. Black respondents with CMD were less likely to be prescribed antidepressants than White respondents and less likely to have reported seeing their GP for a mental health problem; low levels of psychological service access are noted in Indian, Pakistani and Bangladeshi people, despite high levels of primary care consultation.Several reasons for low levels of access to treatments by ethnic minority groups in the UK have been proposed. This includes concerns that general practitioners may not recognise CMD in people of an ethnic minority background, and may not make appropriate onward referral, especially if individuals present with somatic presentations for CMD. Psychological approaches which favour an individualistic versus a collectivist approach may be less acceptable for some ethnic minority groups. Anticipated discrimination from services, alongside differing cultural/explanatory models of distress may play a part. The use of alternative therapies, other forms of health-seeking and informal social networks may also play a role, not just restricted to ethnic minorities.A recent finding is the observation that primary care recognition of depression and prescribing of antidepressants follows strong associations with own ethnic density, that is in areas of higher own ethnic density prescribing of antidepressants are lower than in areas of low own ethnic density for Indian, Pakistani, Bangladeshi and Black African people, but not for Black Caribbean people. This is consistent with work using national data which has suggested a lower prevalence of CMD in areas of higher own ethnic density for UK Bangladeshi and Irish minorities, with similar trends for other minorities. Irrespective of ethnicity, mental health problems may be stigmatised and this may also impact on a person’s willingness to seek help.This mixed methods PhD will use nationally representative data to establish reasons behind the treatment gap for CMD in ethnic minority groups in the UK.
National Centre for Social Research
3 – Health, Biopolitics & Social Inequality