title: Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review.
abstract: BACKGROUND
  Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services.
  
  
  OBJECTIVE
  To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services.
  
  
  METHODS
  Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the 'grey' literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations.
  
  
  RESULTS
  Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18-0.75) than for moderate- or lower-quality studies (range of d 0.18-4.3). The review found only two studies offering weak economic evidence.
  
  
  CONCLUSIONS
  Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK k.s.bhui@qmul.ac.uk.
authors.forename: Kamaldeep S
authors.initials: KS
authors.lastname: Bhui
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Rabeea'h W
authors.initials: RW
authors.lastname: Aslam
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Palinski
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Rose
authors.initials: R
authors.lastname: McCabe
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Mark R D
authors.initials: MR
authors.lastname: Johnson
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: Weich
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Swaran P
authors.initials: SP
authors.lastname: Singh
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Ardino
authors.affiliation: Kamaldeep S. Bhui, MD, FRCPsych, Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, Queen Mary University of London, London; Rabeea'h W. Aslam, MSc, Andrea Palinski, Barts & The London School of Medicine, Queen Mary University of London, London; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Mark R. D. Johnson, Mary Seacole Research Centre, De Montfort University, Leicester; Scott Weich, MD, Swaran P. Singh, MD, Warwick Medical School, University of Warwick, Coventry; Martin Knapp, PhD, Vittoria Ardino, PhD, London School of Economics, London; Ala Szczepura, PhD, Centre for Technology Enabled Health Research (CTEHR), Faculty of Health & Life Sciences, Coventry University, Coventry, UK.
authors.forename: Ala
authors.initials: A
authors.lastname: Szczepura
mesh_terms: D001294:Attitude to Health; D044383:Black People; D017028:Caregivers / Q000523:psychology; D003142:Communication; D004812:Epidemiologic Methods; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000628:therapy; D008605:Mental Health Services / Q000592:standards*; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000592:standards