Cultural inequalities in access to Early Intervention for Psychosis services in the United Kingdom

Abstract

While reviews of evidence suggests that early intervention for psychosis can reduce risk of transition to psychosis, they also highlight that we need to understand early intervention cross culturally and for different health service models. Black and ethnic minority groups are disproportionately disadvantaged in mental healthcare settings in many Western countries and in the United Kingdom and are more likely to be treated in acute settings rather than early intervention. The primary aim of this systematic review was to explore the experiences of South Asian people accessing early intervention services. Five databases were searched, and data were analysed using narrative synthesis from 15 articles that met the inclusion criteria. Only three articles used complementary theories that examine, spirituality, and explanatory models of illness to inform their research. Looking at participants' experiences, six narratives were themed as barriers to access (“declined treatment”, “systemic barriers”, “lack of understanding”, “intersectional stigma and shame”, “hardships”, “interpreters”) and six were themed as facilitators (“support systems”, “factors that influence help-seeking”, “therapies offered”, “what is required”, “no significance”, “what works well”). A recurring finding is the lack of understanding between service users and providers. Therefore, signposting needs improvement, pathways need to become clearer and culturally appropriate treatments need development based on the needs of the end user.

Early intervention in psychosis services: A systematic review and narrative synthesis of barriers and facilitators to seeking access

“… Friskney et al [19]. examine barriers and facilitators to access for people from South Asian heritage specifically, and Loughlin et al[20] review ongoing engagement once people have accessed early intervention services.…”