dc.contributor.author | Halvorsrud , Kristoffer | |
dc.contributor.author | Nazroo, James | |
dc.contributor.author | Otis, Michaela | |
dc.contributor.author | Brown Hajdukova, Eva | |
dc.contributor.author | Bhui, Kamaldeep | |
dc.date.accessioned | 2018-12-20T01:17:04Z | |
dc.date.available | 2018-12-20T01:17:04Z | |
dc.date.issued | 2018-12-12 | |
dc.identifier.citation | Halvorsrud , K , Nazroo , J , Otis , M , Brown Hajdukova , E & Bhui , K 2018 , ' Ethnic inequalities and pathways to care in psychosis in England: a systematic review and meta-analysis ' , BMC Medicine , vol. 16 , no. 1 , 223 , pp. 1-17 . https://doi.org/10.1186/s12916-018-1201-9 | |
dc.identifier.issn | 1741-7015 | |
dc.identifier.other | PURE: 15792085 | |
dc.identifier.other | PURE UUID: 8cd0cb8b-2ee9-43bd-8e1a-e3ed66340ab8 | |
dc.identifier.other | Scopus: 85058347739 | |
dc.identifier.other | ORCID: /0000-0001-6127-7001/work/62751239 | |
dc.identifier.uri | http://hdl.handle.net/2299/20876 | |
dc.description | © The Author(s). 2018 | |
dc.description.abstract | Background: As part of a national programme to tackle ethnic inequalities, we conducted a systematic review and meta-analysis of research on ethnic inequalities in pathways to care for adults with psychosis living in England and/or Wales. Methods: Nine databases were searched from inception to 03.07.17 for previous systematic reviews, including forward and backward citation tracking and a PROSPERO search to identify ongoing reviews. We then carried forward relevant primary studies from included reviews (with the latest meta-analyses reporting on research up to 2012), supplemented by a search on 18.10.17 in MEDLINE, Embase, PsycINFO and CINAHL for primary studies between 2012 and 2017 that had not been covered by previous meta-analyses. Results: Forty studies, all conducted in England, were included for our updated meta-analyses on pathways to care. Relative to the White reference group, elevated rates of civil detentions were found for Black Caribbean (OR = 3.43, 95% CI = 2.68 to 4.40, n = 18), Black African (OR = 3.11, 95% CI = 2.40 to 4.02, n = 6), and South Asian patients (OR = 1.50, 95% CI 1.07 to 2.12, n = 10). Analyses of each Mental Health Act section revealed significantly higher rates for Black people under (civil) Section 2 (OR = 1.53, 95% CI = 1.11 to 2.11, n = 3). Rates in repeat admissions were significantly higher than in first admission for South Asian patients (between-group difference p < 0.01). Some ethnic groups had more police contact (Black African OR = 3.60, 95% CI = 2.15 to 6.05, n = 2; Black Caribbean OR = 2.64, 95% CI = 1.88 to 3.72, n = 8) and criminal justice system involvement (Black Caribbean OR = 2.76, 95% CI = 2.02 to 3.78, n = 5; Black African OR = 1.92, 95% CI = 1.32 to 2.78, n = 3). The White Other patients also showed greater police and criminal justice system involvement than White British patients (OR = 1.49, 95% CI = 1.03 to 2.15, n = 4). General practitioner involvement was less likely for Black than the White reference group. No significant variations over time were found across all the main outcomes. Conclusions: Our updated meta-analyses reveal persisting but not significantly worsening patterns of ethnic inequalities in pathways to psychiatric care, particularly affecting Black groups. This provides a comprehensive evidence base from which to inform policy and practice amidst a prospective Mental Health Act reform. Trial registration: CRD42017071663 | en |
dc.format.extent | 17 | |
dc.language.iso | eng | |
dc.relation.ispartof | BMC Medicine | |
dc.rights | Open | |
dc.subject | Ethnicity | |
dc.subject | Meta-analysis | |
dc.subject | Pathways to care | |
dc.subject | Psychosis | |
dc.subject | Severe mental illness | |
dc.subject | Systematic review | |
dc.subject | Medicine(all) | |
dc.title | Ethnic inequalities and pathways to care in psychosis in England: a systematic review and meta-analysis | en |
dc.contributor.institution | School of Health and Social Work | |
dc.contributor.institution | Centre for Research in Public Health and Community Care | |
dc.contributor.institution | Public Health and Communities | |
dc.description.status | Peer reviewed | |
dc.identifier.url | http://www.scopus.com/inward/record.url?scp=85058347739&partnerID=8YFLogxK | |
dc.relation.school | School of Health and Social Work | |
dc.description.versiontype | Final Published version | |
dcterms.dateAccepted | 2018-12-12 | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | https://doi.org/10.1186/s12916-018-1201-9 | |
rioxxterms.licenseref.uri | http://creativecommons.org/licenses/by/4.0/ | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |
herts.rights.accesstype | Open | |