Ethnicity and pathways to care during first episode psychosis: the role of cultural illness attributions.
BMC Psychiatry
; 15: 287, 2015 Nov 16.
Article
in En
| MEDLINE
| ID: mdl-26573297
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychotic Disorders
/
Mental Health Services
Type of study:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
BMC Psychiatry
Journal subject:
PSIQUIATRIA
Year:
2015
Document type:
Article
Affiliation country:
United kingdom