The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives

Journal article

Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.BACKGROUND: Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these. AIMS: To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare. METHOD: A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts. RESULTS: Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities. CONCLUSIONS: During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups' engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/impact-of-reduced-routine-community-mental-healthcare-on-people-from-minority-ethnic-groups-during-the-covid19-pandemic-qualitative-study-of-stakeholder-perspectives/7627C20E5F00492CD23ECCF77FF521B

Authors: Winsper, C; Bhattacharya, R; Bhui, K; Currie, G; Edge, D

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: The British Journal of Psychiatry
• Volume: 224
• Issue: 5
• Pages: 150-156
• Publication date: 2024-02-12
• DOI: 10.1192/bjp.2024.11
• EISSN: 1472-1465
• ISSN: 0007-1250
• Language: English
• Keywords: Ethnic group; Psychology; Stakeholder; Mental health; Medicine; Psychiatry; Health care; Pandemic; Political science; Coronavirus disease 2019 (COVID-19); Public relations