Mental Health Service Utilisation Disparities Between South Asian, Black Caribbean, and White British Populations in England: A Systematic Review
Background: Inequality in mental health cutting across ethnic groups has existed in England, and the pattern of service uptake varies widely among the South Asian group, Black Caribbean and the White British. Although ethnic minority groups have similar or even greater occurrences of mental health conditions, they have broad disparities in their access, utilisation, and advancement through mental health services. This knowledge of these differences is crucial for creating equal mental health services that can address the needs of England's diverse population. Aim: This systematic review synthesised evidence on disparities in the use of mental health services among South Asian, Black Caribbean, and White British adults in England, focusing on patterns of service access, engagement, and referral to primary, secondary, and crisis mental health services. Methods: Systematic search-PubMed/MEDLINE, PsycINFO, and grey literature (2015-2025), were searched according to the PRISMA 2020 guidelines. Among 876 potential records, 11 studies that passed the eligibility criteria were selected. Checklists were also used as a quality appraisal tool, but to combine the results of quantitative and qualitative methods in theoretical constructs, such as the Behavioural Model by Andersen and the Social Determinants of Health. Results: Thirty to forty per cent less access to voluntary service was observed by the South Asian populations than by the White British populations, with cultural stigma, family honour issues and language barrier presented as the major factors. Black Caribbean residents suffered paradoxically increased contact with crisis services, such as 3.83 times increased Mental Health Act detention rates (95-per cent Confidence Interval: 2.98-4.92), which indicated pathways characterised by crisis-as opposed to preventative-based care. These trends were supported by institutional factors such as underrepresentation of the workforce and insufficient cultural competence of services. Conclusion: The complexity of mental health service utilisation among the ethnic groups is a measure of interactions between the cultural, structural, and institutional factors. These inequities will need culturally responsive interventions, hiring of a workforce where diversity is practised, anti-racism training, and models of community-based and oriented services.
BF Seicoleg, HT Cymunedau. Dosbarthiadau cymdeithasol. Hil, R Meddygaeth (Cyffredinol)
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