Ethnic minority patients are less likely than white British patients to be referred for some mental health support, a major review has found.
According to the NHS Race and Health Observatory (RHO), there are ‘clear ethnic inequalities’ in access to Improving Access to Psychological Therapies (IAPT), with ethnic minority groups less likely to be referred by their GPs and to refer themselves.
Patients from an Asian or Black Caribbean background were more likely to be referred via secondary care than by their GP, when compared to white British patients.
Similarly, children from Black, Asian and mixed ethnic backgrounds were more likely to be referred to CAMHS via their school or other services than by their GP.
However, the ‘largest’ inequality was seen for Black children, who are nearly 10 times as likely to be referred to CAMHS via social services than white children.
The RHO’s review spanned 10-years’ worth of research and identified ‘overwhelming’ evidence of poorer outcomes for ethnic minority patients across all aspects studied, including maternity care and career progression.
Dr Dharmi Kapadia, lead investigator, said that the health of ethnic minority people has been negatively impacted by delays in, or avoidance of, seeking help for health problems due to fear of racist treatment from NHS healthcare professionals.
She said: ‘The evidence on the poor healthcare outcomes for many ethnic minority groups across a range of services is overwhelming, and convincing.’
Josh Keith, senior fellow in data analytics at the Health Foundation, said teh report ‘rightly urges the NHS to do more to make sure that health care services meet the needs of everyone’.
He said: ‘Achieving this will require a better understanding of what is driving these inequalities.Better ethnicity data is crucial to developing this understanding, and to ensuring we can measure progress. The NHS Race & Health Observatory are right to push for improved routine recording of ethnicity data in the NHS.’
Review impact of discrimination by NHS staff
The Observatory called for greater research into the direct and indirect impacts of racial discrimination by NHS staff, processes and access to mental health services.
It also called for the enforcement of statutory guidelines on including ethnic monitoring data in all NHS mental health clinical data to allow for ‘robust’ analysis at national, regional and trust levels.
‘This recommendation will require a dedicated drive by NHS England and NHS Digital to emphasise the importance of collecting and reporting these data, as well as providing the infrastructure to collect, analyse and interpret them,’ it said.
However, a think tank recently claimed the NHS’ structure is ‘misaligned’ with its broader ambition to tackle health inequality, with its ‘one-size-fits-all approach’ making local drivers of inequality ‘harder to act on’.
Government must ‘acknowledge structural racism’ within NHS
The Government must ‘openly acknowledge structural racism within the NHS’ and the barriers that it creates, the BMA has said in response to the report.
Dr Chaand Nagpaul, BMA council chair, called for a ‘cross-government action plan’ with ‘tangible outcomes, timescales and agreement’ across the NHS, developed with involvement from people from ethnic minority backgrounds.
He said: ‘The data in this report is unacceptable and shows that racism within the healthcare service follows millions of people – right from birth to death. This can no longer be ignored – there is a moral duty to put this right as matter of urgency.’
Asked about the report, an NHS spokesperson said: ‘While our latest equality report shows that progress has been made in some areas of the NHS, we are working with the GMC and NHS Employers to ensure that we are addressing these concerns and have appointed senior leaders to take this work forward and monitor progress.
‘The NHS has also set out what local health services should be focusing on over the next year so they can also make improvements in their local communities for patients and will work closely with the RHO to drive forward the recommendations set out in this report.’
It comes after a report found that inequality among the NHS workforce is ‘getting worse’ and is standing in the way of its ability to find and retain staff.