Ethnic differences in receipt of psychological interventions in Early Intervention in Psychosis services in England – a cross-sectional study

Schlief, M ORCID: https://orcid.org/0000-0003-3744-6260, Rich, N, Rains, LS, Baldwin, H ORCID: https://orcid.org/0000-0002-9507-9019, Rojas-Garcia, A, Nyikavaranda, P ORCID: https://orcid.org/0000-0002-9896-6078, Persaud, K, Dare, C, French, P ORCID: https://orcid.org/0000-0003-4300-387X, Lloyd-Evans, B, Crawford, M, Smith, J ORCID: https://orcid.org/0000-0002-0277-1680, Kirkbride, JB ORCID: https://orcid.org/0000-0003-3401-0824 and Johnson, S (2023) Ethnic differences in receipt of psychological interventions in Early Intervention in Psychosis services in England – a cross-sectional study. Psychiatry Research, 330. 115529. ISSN 0165-1781

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Abstract

There is some evidence of differences in psychosis care provision by ethnicity. We investigated variations in the receipt of Cognitive Behavioural Therapy for psychosis (CBTp) and family intervention across ethnic groups in Early Intervention in Psychosis (EIP) teams throughout England, where national policy mandates offering these interventions to all. We included data on 29,610 service users from the National Clinical Audit of Psychosis (NCAP), collected between 2018 and 2021. We conducted mixed effects logistic regression analyses to examine odds ratios of receiving an intervention (CBTp, family intervention, either intervention) across 17 ethnic groups while accounting for the effect of years and variance between teams and adjusting for individual- (age, gender, occupational status) and team-level covariates (care-coordinator caseload, inequalities strategies). Compared with White British people, every minoritized ethnic group, except those of mixed Asian-White and mixed Black African-White ethnicities, had significantly lower adjusted odds of receiving CBTp. People of Black African, Black Caribbean, non-African/Caribbean Black, non-British/Irish White, and of “any other” ethnicity also experienced significantly lower adjusted odds of receiving family intervention. Pervasive inequalities in receiving CBTp for first episode psychosis exist for almost all minoritized ethnic groups, and family intervention for many groups. Investigating how these inequalities arise should be a research priority.