What works to support better access to mental health services (from primary care to inpatients) for minority groups to reduce inequalities? A rapid evidence summary

Background

Inequalities in access to mental health services is an important societal issue, and it is known that ethnic minority groups experience more barriers to mental health services, and poorer mental health outcomes, than those from non-ethnic minority groups.

Evidence suggests interventions improving access and engagement with mental health services can help reduce these inequalities.

Aim

This rapid evidence summary aims to explore which interventions work to improve equal access, engagement, use and provision of mental health services for these groups.

A range of studies between 2006 – 2023 were reviewed.

Findings

Both across the UK and internationally, the search found lots of evidence on the topics of:

• Barriers and facilitators to accessing mental health care for these groups
• Mental health promotion and prevention, and treatment of mental health conditions
• Cultural adaptations of psychological interventions

Some research was found on improving mental health care access and experience of these groups. However, strong conclusions could not be made from these studies due to uncertainty in the evidence.

The most common recommendations to improve equality in mental health care were:

• language and cultural adaptations
• education of healthcare professionals
• employing ethnically diverse staff
• better information provision
• different sectors working in collaboration
• improving and facilitating referral routes and pathways
• specialist services for minority groups (including outreach services, patient education and skill development)
• involving communities

The evidence suggests that culturally adapted interventions for mental health promotion, prevention or treatment may lead to positive outcomes.

However, it is unclear which elements of these methods work, and for which cultural groups.

Additionally, it is unclear how much better the outcomes of cultural adaptations are compared to non-adapted interventions, showing a need for a high-quality well-designed randomised control trials to reliably compare.

Next steps

There is considerable evidence of the barriers faced by ethnic minority groups when accessing mental health services. However, there is limited evidence on how effective interventions are in improving access to mental health care across ethnic minority groups.

While there is information available around interventions supporting refugees’ and asylum seekers’ access to primary mental health care or specialised clinics (e.g., pregnancy and post-partum), findings related solely to mental health care cannot be extracted.

A focused rapid review is planned for Summer 2024 on effectiveness of interventions to enhance equitable or overall access to mental health services by ethnic minority groups.

Author: Olivia Gallen

 

The full report can be accessed here: https://www.medrxiv.org/content/10.1101/2024.02.28.24303432v2