Disparate patterns of hospitalisation reflect unmet needs and persistent ethnic inequalities in mental health care: the Scottish health and ethnicity linkage study

Bansal, Narinder; Bhopal, Raj; Netto, Gina; Lyons, Donald; Steiner, Markus; Sashidharan, S. P.

doi:10.1080/13557858.2013.814764

Cited by 51 publications

(49 citation statements)

References 54 publications

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“…From overlapping papers, Selten et al (2001) was selected instead of Veling et al (2006) and Kirkbride et al (2008) instead of Coid et al (2008). f Eight studies that reported an effect size adjusted for age and sex, as well as an effect size adjusted for age, sex and SES (Selten, 2001;Leao et al, 2006;Weiser et al, 2008;Kirkbride et al, 2008;Bansal et al, 2014;Hollander et al, 2016;Manhica et al, 2016;Kirkbride et al, 2017aKirkbride et al, , 2017b plus two studies that reported an effect size adjusted for age, sex and SES (Barghadouch et al, 2016;Markkula et al, 2017). g Derived from the above eight studies that reported an effect size adjusted for age and sex, and an effect size adjusted for age, sex and SES.…”

Section: Discussionmentioning

confidence: 99%

Migration and psychosis: a meta-analysis of incidence studies

2019

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BackgroundThe aims of this meta-analysis are (i) to estimate the pooled relative risk (RR) of developing non-affective psychotic disorder (NAPD) and affective psychotic disorder (APD) among migrants and their children; (ii) to adjust these results for socioeconomic status (SES); (iii) to examine the sources of heterogeneity that underlie the risk of NAPD.MethodsWe included population-based incidence studies that reported an age-adjusted RR with 95% confidence interval (CI) published 1 January 1977–12 October 2017 and used a random-effects model.ResultsWe retrieved studies performed in Europe (n = 43), Israel (n = 3), Canada (n = 2) and Australia (n = 1). The meta-analysis yielded a RR, adjusted for age and sex, of 2.13 (95% CI 1.99–2.27) for NAPD and 2.94 (95% CI 2.28–3.79) for APD. The RRs diminished, but persisted after adjustment for SES. With reference to NAPD: a personal or parental history of migration to Europe from countries outside Europe was associated with a higher RR (RR = 2.94, 95% CI 2.63–3.29) than migration within Europe (RR = 1.88, 95% 1.62–2.18). The corresponding RR was lower in Israel (RR = 1.22; 0.99–1.50) and Canada (RR = 1.21; 0.85–1.74). The RR was highest among individuals with a black skin colour (RR = 4.19, 95% CI 3.42–5.14). The evidence of a difference in risk between first and second generation was insufficient.ConclusionsPositive selection may explain the low risk in Canada, while the change from exclusion to inclusion may do the same in Israel. Given the high risks among migrants from developing countries in Europe, social exclusion may have a pathogenic role.

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Section: Discussionmentioning

confidence: 99%

Migration and psychosis: a meta-analysis of incidence studies

2019

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“…As discussed, there is additionally long-standing evidence to suggest that psychiatrists diagnose potential symptoms of mental illness differently depending on the ethnicity of the patient (Bansal et al, 2014;Weich et al, 2014), and perceptions of the SA population as a homogeneous group have been criticised for ignoring the demographic variability and intragroup diversity of the population and giving rise to cultural stereotypes (Burr, 2002). These stereotypes, which are said to stem from a belief that South Asian culture is patriarchal, repressive and inferior to Western culture, have the potential to misdirect diagnosis and also influence standards of care and treatment pathways (Burr, 2002), acting as a further barrier to accessing services.…”

Section: Help-seekingmentioning

confidence: 99%

“…Concerns about mental healthcare inequalities for British BME populations are tangled up with discussions about whether these populations are inappropriately over-represented, for example in terms of psychiatric hospitalisation, or whether rates of mental illness are really higher. Two recent studies (Bansal et al, 2014;Weich et al, 2014), the latter of which had a sample of 1.2 million patients, found higher rates of psychiatric hospitalisation for South Asians than for White people and concluded that these findings evidenced race-based inequality in treatment. However, there is also significant research which points to higher levels of psychological distress in the British South Asian population (e.g.…”

Section: Introductionmentioning

confidence: 99%

Barriers to counselling experienced by British South Asian women: A thematic analysis exploration

Moller

Burgess

Jogiyat

2016

Couns and Psychother Res

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AimThe objective of this study was to explore the attitudes and beliefs that second‐generation South Asian women living in Britain hold about counselling, with a particular focus on how these beliefs may impact on the process of help‐seeking for psychological distress.MethodologyEighty‐two second‐generation British South Asian women aged 18–40 (M = 24), the majority of whom (92%) had no experience of counselling, responded to a qualitative survey. The data were analysed with thematic analysis.FindingsAn over‐arching theme of ‘Stereotyping’ was identified from the analysis; this theme emerged from the data under four main categories which were best summarised by the following open‐ended statements: ‘White counsellors are…’, ‘Asian counsellors are…’, ‘Counselling is…’ and ‘People with psychological problems are…’. Participants identified attitudes and beliefs about counselling, counsellors and psychological distress which revealed widespread generalisations and stereotypes. Some of these views were culturally specific whilst others reflected stereotypes commonly held by the population as a whole, but they all had the potential to act as barriers to help‐seeking.ImplicationsImplications from the study findings are that services should consider how to address stereotypes which may make it harder for South Asian women to seek help from counselling services if they are experiencing psychological distress. This might involve initiatives to address beliefs, attitudes and behaviours that may act as a barrier to help‐seeking. In addition, practitioners should understand that their ethnicity and religious identity may have significant meaning for this population.

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“…Further, migrants have been found to have higher hospitalisation rates and disproportionately high involuntary hospitalisation rates relative to their Anglo‐Australian counterparts (Bansal et al . , Stolk et al . ).…”

Section: Discussionmentioning

confidence: 95%

Agency, activation and compatriots: the influence of social networks on health‐seeking behaviours among Sri Lankan migrants and Anglo‐Australians with depression

Antoniades

Mazza

Brijnath

2018

Sociology Health & Illness

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The nexus between social networks and illness behaviours is important in uptake of health care, however scant research has explored this relationship in South Asian migrants living with mental illness. We explored the interplay between culture, social networks and health seeking in Sri Lankan migrants and Anglo-Australians living with depression. Forty-eight in-depth interviews were conducted and data were analysed through the theoretical prism of the network episode model. Results showed that social networks were important in negotiating care. Decisions to initiate care occurred along a continuum of choice and agency; some took charge of their care, others were coerced into care, however some Sri Lankan migrants were led through various informal channels of care. Selective activation of compatriots - those perceived to understand mental illness-became increasingly important to participants through their illness careers. Compatriots were considered of greater benefit as participants progressed through depression than otherwise meaningful social networks based on ethnicity, culture and kinship. We argue that the role of social networks is pivotal in uptake of formal care, and engaging with communities to improve responses of social networks to mental illnesses may provide a bottom-up avenue for improving uptake of mental health services in migrant communities.

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Disparate patterns of hospitalisation reflect unmet needs and persistent ethnic inequalities in mental health care: the Scottish health and ethnicity linkage study

Cited by 51 publications

References 54 publications

Migration and psychosis: a meta-analysis of incidence studies

Migration and psychosis: a meta-analysis of incidence studies

Barriers to counselling experienced by British South Asian women: A thematic analysis exploration

Agency, activation and compatriots: the influence of social networks on health‐seeking behaviours among Sri Lankan migrants and Anglo‐Australians with depression

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