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Pathways to care and ethnicity. 2: Source of referral and help-seeking

Report from the ÆSOP study

Division of Psychological Medicine, Institute of Psychiatry, London, UK

GERARD HUTCHINSON, MRCPsych

Psychiatry Unit, Department of Clinical Medical Sciences, University of the West Indies, Trinidad

HEMANT BAGALKOTE, MRCPsych

Department of Psychiatry, University of Nottingham

KEVIN MORGAN, PhD, PAUL FEARON, MRCPsych, PAOLA DAZZAN, MRCPsych and JANE BOYDELL, MRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London

KWAME MCKENZIE, MRCPsych

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London

GLYNN HARRISON, FRCPsych

Division of Psychiatry, University of Bristol

ROBIN MURRAY, FRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London

PETER JONES, FRCPsych

Department of Psychiatry, University of Cambridge

TOM CRAIG, FRCPsych and JULIAN LEFF, FRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London, UK

on behalf of the ÆSOP Study Group

Correspondence: Craig Morgan, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.Tel: +44(0)20 7848 0351; e-mail: spjucrm{at}iop.kcl.ac.uk

Declaration of interest None.

See Part 1, pp. 281–289, this issue.

Background Previous research has found that African–Caribbean and Black African patients are likely to come into contact with mental health services via more negative routes, when compared with White patients. We soughtto investigate pathways to mental health care and ethnicityin a sample of patients with a first episode of psychosis drawn from two UK centres.

Method We included all White British, other White, African–Caribbean and Black African patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes.

Results Compared with White British patients, general practitioner referral was less frequent for both African–Caribbean and Black African patients and referral by a criminal justice agency was more common. With the exception of criminal justice referrals for Black African patients, these findings remained significant after adjusting for potential confounders.

Conclusions These findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals.

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