A new study examining ethnic differences in patients' experiences of specialist community mental health services has found that relative to White British people, Asian service users were most likely to respond negatively. In some aspects of services, no ethnic differences were apparent.

Minority ethnic groups in the UK are reported to have a poor experience of mental health services, but until now comparative information has been scarce. This study was published in the October 2007 issue of the British Journal of Psychiatry.

It analysed ethnic variations in patient experience as reported in the 2004 and 2005 surveys of 26,625 and 25,143 users of community mental health services respectively across all NHS mental health and primary care trusts providing specialist community mental health services in England.

10% of the respondents surveyed were of Black and minority ethnic origin. Self-reported mental health status was poor/very poor in about 25% of respondents in most ethnic groups in 2004, and about 20% in 2005. In both surveys, the proportion was significantly lower in respondents from the Black group (15.2% and 12.1% respectively).

In summary, relative to the White British group, the main ethnic differences were for the Asian group, who responded negatively to some questions about access to specialist community mental health services (e.g. had a copy of their care plan or had a care review in the past year).

Respondents from the Black group were more likely than White British to say that they had seen a community psychiatric nurse (CPN), had had a care review in the preceding year, and had been told their care coordinator. Overall, minority ethnic groups were less likely to report receiving talking therapies in the last year.

Age, employment status, hospital admission, detention under the Mental Health Act (1983) and Care Programme Approach status were stronger and more consistent predictors of responses than ethnicity. The strongest predictor was self-reported health status. Reviews of patient satisfaction surveys have similarly shown a positive association of patient satisfaction with increasing age and better health status.

Analysis of the 2005 survey showed few or no differences between the proportions of White British patients and minority ethnic patients seeing a mental health professional in the past 12 months, or those on medication. Although this study is limited to users of community mental health services, this is an important finding, since minority ethnic groups are widely reported to be more likely to receive medication.

For several questions asked of patients, no ethnic difference was apparent. Where negative experiences were apparent, they applied in the main to the Asian group, who were more likely than the White British to say that they had not received some services.
The authors of the study comment that the results indicate the need for improvement in mental health services for ethnic groups.

"Ethnic variations in the experiences of mental health service users in England: Results of a national patient survey programme"
Raleigh VS, Irons R, Hawke E, Scobie S, Cook A, Reeves R, Petruckevitch A and Harrison J (2007)
British Journal of Psychiatry, 191, 304-312.
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