London (Parliament Politic Magazine) – Individuals from Black and minority ethnic backgrounds face reduced accessibility to NHS Talking Therapies services and encounter prolonged waiting times, according to a report. The NHS Race & Health Observatory conducted an analysis of a decade of anonymized patient data, revealing that compared to white British patients, individuals from minority ethnic backgrounds are less likely to undergo a course of treatment following assessment. The report also highlighted poorer outcomes for most minority ethnic groups, with the exception of Chinese individuals, although this disparity has shown some improvement in recent years.
Barriers Faced by Minority Ethnic Patients in NHS
The report concluded that addressing and even eliminating poor outcomes is possible through improved access and the provision of culturally sensitive therapy. Individuals from Bangladeshi, Pakistani, and Black Caribbean backgrounds were identified as having particularly unfavorable outcomes.
This report highlighted issues such as older individuals relying on younger relatives for interpretation and a lack of understanding regarding the importance of religion and belief. Additionally, stigma surrounding mental health was noted, with feelings of shame, guilt, and a desire to conceal problems due to fears of community exclusion among certain individuals.
The identified inequalities were also associated with greater symptom severity during the initial assessments by NHS Talking Therapies services, formerly known as IAPT but rebranded earlier this year. The report revealed that a Positive Practice Guide, published in 2019 for services to adopt, does not seem to have been uniformly applied, although commendable instances were recognized.
The report suggested that Integrated Care Boards (ICBs) and those in leadership positions should utilize local data to comprehend the needs of their communities, pinpoint resources, and secure funding to address these inequalities. Additionally, services were advised to ensure that all interventions are delivered in a culturally sensitive manner.
Gaps Persist in Access and Outcomes for Mental Health
Dr. Habib Naqvi, Chief Executive of the NHS Race and Health Observatory, stated, “We acknowledge that significant gaps persist in access and outcomes for mental health support and talking therapies across various ethnic groups.” ‘There are many people from Black and minority ethnic communities struggling with their mental health, and yet they are less likely to be referred to talking therapies and have poorer experiences and outcomes once they are referred.
‘It’s vital that we take a serious look at the findings of this review – reflect on what has been effective in the past, and address how service provision can be more inclusive and equitable across all communities.’
Professor Steve Pilling, Academic and Strategic Director of the National Collaborating Centre for Mental Health, commented, “The findings of this review demonstrate strong evidence to offer effective mental health support to individuals, especially those in the most underserved groups. We anticipate that this will spur practical and effective changes, with confidence that effective monitoring of outcomes will support these efforts.”
Saffron Cordery, Deputy Chief Executive of NHS Providers, expressed concern over the highlighted disparities in the report, stating, “It is deeply concerning that inadequate access to talking therapies and extended assessment waits are resulting in poorer outcomes and experiences for individuals from ethnic minority backgrounds.“
A Closer Look at Minority Ethnic Patients’ Access to NHS
While this research identified areas of commendable practice and noted some enhancements in NHS talking therapies, trust leaders acknowledge that there is a pressing need for more extensive efforts to address entrenched structural racism, bias, and discrimination within health services. These factors contribute to diminished physical and mental health outcomes for ethnic minority groups and individuals residing in economically deprived areas.
However, the spokesperson emphasized that broader issues require attention as well. “In addition to a sustained commitment to supporting local health systems in addressing disparities in access, experience, and outcomes of mental healthcare, it is crucial for the government to take decisive action on broader societal factors such as housing and employment that contribute to overarching inequalities.”
Participants who valued their faith expressed disappointment when therapists lacked an understanding of the significance of religion and belief. Some individuals associated negative connotations with ‘madness,’ leading to feelings of shame, guilt, and a desire to conceal mental health problems for fear of community exclusion.
Another notable aspect was the importance of therapists being educated and trained on the specific needs of the population they serve, including characteristics such as ethnicity, age, and gender that align with the preferences of the person receiving treatment.