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

Singh, S.P. and Brown, L. and Winsper, C. and Gajwani, R. and Islam, Z. and Jasani, R. and Parsons, H. and Rabiee-Khan, Fatemeh and Birchwood, M. (2015) Ethnicity and pathways to care during first episode psychosis: The role of cultural illness attributions. BMC Psychiatry. ISSN 1471244X (ISSN)

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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. © 2015 Singh et al.

Item Type: Article
Identification Number:
16 November 2015Published Online
Uncontrolled Keywords: Compulsory detention, Early intervention, Ethnicity, First episode psychosis, Illness attributions
Subjects: CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific)
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Faculty of Health, Education and Life Sciences > School of Health Sciences
Depositing User: Users 18 not found.
Date Deposited: 03 Jan 2017 13:42
Last Modified: 03 Mar 2022 17:15

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