Are ethnic differences in pathways to care for psychosis in England reducing?: Analysis of two population-based studies of first-episode psychosis in South London

Studies in the 1990s showed that, compared with the majority populations, people from minority ethnic groups in England were more likely to access psychiatric care via crisis routes. This chapter, and the studies it is based on, explore whether this adverse pattern continues. The authors analysed data from two population-based studies of first-episode psychosis (FEP) carried out 15 years apart. Participants for the studies were 193 FEP patients, aged 18–35 years, presenting to psychiatric care in South London between 1997 and 1999, and 265 FEP patients presenting in 2010–2012. The outcome measure was source of referral during first-episode psychosis. Results of the studies showed that, compared with 15 years ago, ethnic differences were not evident for police or GP involvement. However, ethnic minorities were more likely to access care via accident and emergency departments (Black Caribbean: adj. OR = 48.89; 95% CI = 3.49–684.71; Black African: adj. OR = 7.34; 95% CI = 1.15–46.74). It seems, from these results, that the disparities in pathways to care appear to be narrowing. This may be explained by changing socioeconomic factors and family involvement.