Ethnicity and pathways to care during first episode psychosis: the role of cultural illness attributions

Singh, S. P., Brown, L., Winsper, C., Gajwani, R. , Islam, Z., Jasani, R., Parsons, H., Rabbie-Khan, F. and Birchwood, M. (2015) Ethnicity and pathways to care during first episode psychosis: the role of cultural illness attributions. BMC Psychiatry, 15, 287. (doi: 10.1186/s12888-015-0665-9) (PMID:26573297) (PMCID:PMC4647639)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gajwani, Dr Ruchika
Authors: Singh, S. P., Brown, L., Winsper, C., Gajwani, R., Islam, Z., Jasani, R., Parsons, H., Rabbie-Khan, F., and Birchwood, M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:BMC Psychiatry
Publisher:BioMed Central Ltd.
ISSN:1471-244X
ISSN (Online):1471-244X
Copyright Holders:Copyright © 2015 Singh et al.
First Published:First published in BMC Psychiatry 15:287
Publisher Policy:Reproduced under a Creative Commons License

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