Journal Article

Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: Systematic review

Singh, Swaran P., Szczepura, Ala, Aslam, Rabeea'h W., Palinski, Andrea, Knapp, Martin, McCabe, Rose, Johnson, Mark R. D., Bhui, Kamaldeep S., Weich, Scott, Ardino, Vittoria

2015

Overview

Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services. To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services. Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the 'grey' literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations. Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18-0.75) than for moderate- or lower-quality studies (range of d 0.18-4.3). The review found only two studies offering weak economic evidence. Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices.

• Publisher: Cambridge University Press,Royal College of Psychiatrists
• Subject: Attitude to Health / Black People / Caregivers / Caregivers - psychology / Clinical trials / Communication / Drugs / Epidemiologic Methods / Ethnic groups / Ethnicity / Ethnography / Experts / Female / Health Services Accessibility / Healthcare Disparities - ethnology / Humans / Inequality / Intervention / Male / Medical research / Mental depression / Mental disorders / Mental Disorders - ethnology / Mental Disorders - therapy / Mental health services / Mental Health Services - standards / Minority & ethnic groups / Minority groups / Patient Satisfaction / Patients / Professional-Patient Relations / Psychiatric services / Psychiatry / Psychotherapy / Psychotherapy - standards / Registration / Review / Review Articles / Services / Stigma / Systematic review