Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review.
BACKGROUND
Inequalities of service use across ethnic groups are important to policy makers, service providers and service users.


OBJECTIVE
To identify ethnic variations in pathways to specialist mental health care, continuity of contact, voluntary and compulsory psychiatric in-patient admissions; to assess the methodological strength of the findings.


METHODS
A systematic review of all quantitative studies comparing use of mental health services by more than one ethnic group in the UK. Narrative analysis supplemented by meta-analysis, where appropriate.


RESULTS
Most studies compared Black and White patients, finding higher rates of in-patient admission among Black patients. The pooled odds ratio for compulsory admission, Black patients compared with White patients, was 4.31 (95% CI 3.33-5.58). Black patients had more complex pathways to specialist care, with some evidence of ethnic variations in primary care assessments.


CONCLUSIONS
There is strong evidence of variation between ethnic groups for voluntary and compulsory admissions, and some evidence of variation in pathways to specialist care.
Bhui
Kamaldeep
K
Department of Psychiatry, Barts and the London, Queen Mary's School of Medicine and Dentistry, UK. k.s.bhui@mds.qmw.ac.uk
Stansfeld
Stephen
S
Hull
Sally
S
Priebe
Stefan
S
Mole
Funke
F
Feder
Gene
G
D003134:Commitment of Persons with Psychiatric Disorders; D003266:Continuity of Patient Care; D019091:Critical Pathways; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D006113:United Kingdom