Pathways to care and ethnicity. 2: Source of referral and help-seeking. Report from the AESOP study.
BACKGROUND
Previous research has found that African-Caribbean and Black African patients are likely to come into contact with mental health services via more negative routes, when compared with White patients. We sought to investigate pathways to mental health care and ethnicity in a sample of patients with a first episode of psychosis drawn from two UK centres.


METHODS
We included all White British, other White, African-Caribbean and Black African patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes.


RESULTS
Compared with White British patients, general practitioner referral was less frequent for both African-Caribbean and Black African patients and referral by a criminal justice agency was more common. With the exception of criminal justice referrals for Black African patients, these findings remained significant after adjusting for potential confounders.


CONCLUSIONS
These findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals.
Morgan
C
C
Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. spjucrm@iop.kcl.ac.uk
Mallett
R
R
Hutchinson
G
G
Bagalkote
H
H
Morgan
K
K
Fearon
P
P
Dazzan
P
P
Boydell
J
J
McKenzie
K
K
Harrison
G
G
Murray
R
R
Jones
P
P
Craig
T
T
Leff
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000208:ethnology; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D003416:Criminal Law / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011618:Psychotic Disorders / Q000208:ethnology* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D014900:West Indies / Q000208:ethnology