Differences in treatment approach between ethnic groups

Publication Date13 June 2016
Date13 June 2016
AuthorSteve Sizmur,Andrew McCulloch
SubjectHealth & social care,Mental health
Differences in treatment approach
between ethnic groups
Steve Sizmur and Andrew McCulloch
Steve Sizmur is the Chief
Statistician and Andrew
McCulloch is the CEO, both at
the Picker Institute Europe,
Oxford, UK.
Purpose The mental health experience of people from ethnic minorities differs from that of the majority,
including differential access to services and treatments. The 2014 National Health Service (NHS) Community
Mental Health survey gathered data from 13,787 individuals in 57 NHS trusts in England, providing one
means of monitoring such experience. The purpose of this paper is to analyse survey variables describing
treatments offered to respondents for evidence of differential access or treatment experiences associated
with ethnicity.
Design/methodology/approach Secondary analysis of survey data. Proportions for target variables
were modelled using multilevel logit models. Ethnic background, age and gender were entered as
independent variables.
Findings Respondents in most minority groups were more likely to be on the care programme approach
(CPA) to provision than white British respondents and less likely to report receiving psychological treatments.
Unmet need for psychological treatment was relatively high in certain Asian groups. Medication use was
consistently high across respondents, but differences by ethnic background were evident.
Research limitations/implications The study was dependent on existing survey data of a relatively
limited nature, and potentially subject to non-response bias. The survey excludes users of certain types of
service, giving an incomplete cross-section.
Originality/value This represents a novel use of the data from the Community Mental Health survey, and
complements evidence from a range of other sources. The findings mostly concur with other evidence but
provide important new data in relation to medication, unmet needs in psychotherapy and use of the CPA.
They remain suggestive of the complex nature of discrimination and/or unequal access and treatment in
mental health services.
Keywords Community Mental Health, Ethnic background, Treatment approaches
Paper type Research paper
Interrogating the 2014 Community Mental Health survey data to look for differences in the way
that ethnic minorities are offered mental health services.
This paper uses a novel source of data, a national service-user survey, to add to the evidence
base concerning how ethnic minorities are offered mental health services in the community, and
to investigate whether previously reported differential access to care and treatment persists.
In total, 14 per cent of the 2011 population of England and Wales were from a non-white ethnic
minority (Office for National Statistics, 2012). This group is diverse, comprising established
communities, new migrants, refugees and asylum-seekers. There is a muchhigher concentration
of ethnic minorities in cities (Office for National Statistics, 2012). The mental health experience of
people fromethnic minorities is also diverseand varies across white Europeangroups, people who
Received 19 May 2015
Revised 9 October 2015
Accepted 18 December 2015
Declaration of interest: none.
No specific funding was allocated
to this work.
DOI 10.1108/MHRJ-05-2015-0016 VOL. 21 NO. 2 2016, pp. 73-84, © Emerald Group Publishing Limited, ISSN 1361-9322
PAG E 73

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