Abstract

Concerns persist that some ethnic minority groups experience longstanding mental health inequalities in England. It is unclear if these have changed over time. To assess the prevalence of common mental disorders (CMDs) and treatment receipt by ethnicity, and changes over time, using data from the nationally representative probability sample in the Adult Psychiatric Morbidity Surveys. We used survey data from 2007 (n = 7187) and 2014 (n = 7413). A Clinical Interview Schedule - Revised score of ≥12 indicated presence of a CMD. Treatment receipt included current antidepressant use; any counselling or therapy; seeing a general practitioner about mental health; or seeing a community psychiatrist, psychologist or psychiatric nurse, in the past 12 months. Multivariable logistic regression assessed CMD prevalence and treatment receipt by ethnicity. CMD prevalence was highest in the Black group; ethnic variation was explained by demographic and socioeconomic factors. After adjustment for these factors and CMDs, odds ratios for treatment receipt were lower for the Asian (0.62, 95% CI 0.39-1.00) and White Other (0.58, 95% CI 0.38-0.87) groups in 2014, compared with the White British group; for the Black group, this inequality appeared to be widening over time (2007 treatment receipt odds ratio 0.68, 95% CI 0.38-1.23; 2014 treatment receipt odds ratio 0.23, 95% CI 0.13-0.40; survey year interaction P < 0.0001). Treatment receipt was lower for all ethnic minority groups compared with the White British group, and lowest among Black people, for whom inequalities appear to be widening over time. Addressing socioeconomic inequality could reduce ethnic inequalities in mental health problems, but this does not explain pronounced treatment inequalities.

Highlights

  • Concerns persist that some ethnic minority groups experience longstanding mental health inequalities in England

  • After adjustment for these factors and common mental disorders (CMDs), odds ratios for treatment receipt were lower for the Asian (0.62, 95% CI 0.39−1.00) and White Other (0.58, 95% CI 0.38–0.87) groups in 2014, compared with the White British group; for the Black group, this inequality appeared to be widening over time (2007 treatment receipt odds ratio 0.68, 95% CI 0.38−1.23; 2014 treatment receipt odds ratio 0.23, 95% CI 0.13−0.40; survey year interaction P < 0.0001)

  • Treatment receipt was lower for all ethnic minority groups compared with the White British group, and lowest among Black people, for whom inequalities appear to be widening over time

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Summary

Methods

We used survey data from 2007 (n = 7187) and 2014 (n = 7413). Treatment receipt included current antidepressant use; any counselling or therapy; seeing a general practitioner about mental health; or seeing a community psychiatrist, psychologist or psychiatric nurse, in the past 12 months. Multivariable logistic regression assessed CMD prevalence and treatment receipt by ethnicity. Participants and setting APMS interviewed people aged ≥16 years in England about their mental health, health service use, demographic characteristics and socioeconomic circumstances. Details on the survey and sampling have been published elsewhere.[10 ] Measures Ethnicity. Both APMS waves used Office for National Statistics harmonised questions on self-identified ethnic group or background, which contain up to 18 subcategories. The five broad ethnic groups analysed here are White British; White Other; Black (including Black African, Black Caribbean and Black British); Asian (including Asian British, Bangladeshi, Indian and Pakistani); and Mixed, Multiple or Other Ethnic Group

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