Ethnic inequalities in the use of secondary and tertiary mental health services among patients with obsessive-compulsive disorder

Lorena Fernández de la Cruz; Marta Llorens; Amita Jassi; Georgina Krebs; Pablo Vidal-Ribas; Joaquim Radua; Stephani L Hatch; Dinesh Bhugra; Isobel Heyman; Bruce Clark; David Mataix-Cols

doi:10.1192/bjp.bp.114.154062

Ethnic inequalities in the use of secondary and tertiary mental health services among patients with obsessive-compulsive disorder

Br J Psychiatry. 2015 Dec;207(6):530-5. doi: 10.1192/bjp.bp.114.154062. Epub 2015 Jul 23.

Affiliation

¹ Lorena Fernández de la Cruz, PhD, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Marta Llorens, MD, King's College London, Institute of Psychiatry, London, UK; Amita Jassi, DClinPsy, National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK; Georgina Krebs, DClinPsy, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London and National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK; Pablo Vidal-Ribas, MSc, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK; Joaquim Radua, MD, PhD, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK, Fundació per a la Investigació i la Docència Maria Angustias Giménez Research Unit, Germanes Hospitalàries, Barcelona and Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; Stephani L. Hatch, PhD, Dinesh Bhugra, PhD, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK; Isobel Heyman, MBBS, PhD, FRCPsych, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK, National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London and Great Ormond Street Hospital for Children, London, UK; Bruce Clark, MD, National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK; David Mataix-Cols, PhD, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, National and Specialist OCD Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK and Department of Clinical Neu

PMID: 26206866
DOI: 10.1192/bjp.bp.114.154062

Abstract

Background: Obsessive-compulsive disorder (OCD) has similar prevalence rates across ethnic groups. However, ethnic minorities are underrepresented in clinical trials of OCD. It is unclear whether this is also the case in clinical services.

Aims: To explore whether ethnic minorities with OCD are underrepresented in secondary and tertiary mental health services in the South London and Maudsley (SLaM) NHS Foundation Trust.

Method: The ethnic distribution of patients with OCD seen between 1999 and 2013 in SLaM (n = 1528) was compared with that of the general population in the catchment area using census data. A cohort of patients with depression (n = 22 716) was used for comparative purposes.

Results: Ethnic minorities with OCD were severely underrepresented across services (-57%, 95% CI -62% to -52%). The magnitude of the observed inequalities was significantly more pronounced than in depression (-29%, 95% CI -31% to -27%).

Conclusions: There is a clear need to understand the reasons behind such ethnic inequalities and implement measures to reduce them.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
Depressive Disorder / epidemiology*
Diagnostic and Statistical Manual of Mental Disorders
Ethnicity / psychology*
Healthcare Disparities / statistics & numerical data*
Humans
London / ethnology
Mental Health Services / statistics & numerical data*
Obsessive-Compulsive Disorder / complications*
Obsessive-Compulsive Disorder / ethnology*
Registries
Secondary Care Centers
Tertiary Care Centers