Singh, Swaran P., Brown, Luke J., Winsper, Catherine, Gajwani, Ruchika, Islam, Zoebia, Jasani, Rubina, Parsons, Helen, Rabbie-Khan, Fatemeh and Birchwood, M. J. (2015) Ethnicity and pathways to care during first episode psychosis : the role of cultural illness attributions. BMC Psychiatry, 15 (1). 287. doi:10.1186/s12888-015-0665-9 ISSN 1471-244X.

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Abstract

Background:
Studies demonstrate ethnic variations in pathways to care during first episode psychosis (FEP). There are no extant studies, however, that have statistically examined the influence of culturally mediated illness attributions on these variations.

Methods:
We conducted an observational study of 123 (45 White; 35 Black; 43 Asian) patients recruited over a two-year period from an Early Intervention Service (EIS) in Birmingham, UK. Sociodemographic factors (age; sex; education; country of birth; religious practice; marital status; living alone), duration of untreated psychosis (DUP), service contacts (general practitioner; emergency services; faith-based; compulsory detention; criminal justice) and illness attributions (“individual;” “natural;” “social;” “supernatural;” “no attribution”) were assessed.

Results:
Ethnic groups did not differ in DUP (p = 0.86). Asian patients were more likely to report supernatural illness attributions in comparison to White (Odds Ratio: 4.02; 95 % Confidence Intervals: 1.52, 10.62) and Black (OR: 3.48; 95 % CI: 1.25, 9.67) patients. In logistic regressions controlling for confounders and illness attributions, Black (OR: 14.00; 95 % CI: 1.30, 151.11) and Asian (OR: 13.29; 95 % CI: 1.26, 140.47) patients were more likely to consult faith-based institutions than White patients. Black patients were more likely to be compulsorily detained than White patients (OR: 4.56; 95 % CI: 1.40, 14.85).

Conclusion:
Illness attributions and sociodemographic confounders do not fully explain the ethnic tendency to seek out faith-based institutions. While Asian and Black patients are more likely to seek help from faith-based organisations, this does not appear to lead to a delay in contact with mental health services.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Psychoses, Mental illness, Ethnicity, Mentally ill -- Commitment and detention, Psychoses -- Treatment
Journal or Publication Title:	BMC Psychiatry
Publisher:	BioMed Central Ltd.
ISSN:	1471-244X
Official Date:	16 October 2015
Dates:	Date Event 16 October 2015 Published 28 October 2015 Accepted 30 July 2015 Submitted
Volume:	15
Number:	1
Article Number:	287
DOI:	10.1186/s12888-015-0665-9
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	7 January 2016
Date of first compliant Open Access:	8 January 2016
Funder:	National Institute for Health Research (Great Britain) (NIHR)
Grant number:	RP-PG-0606-1151

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