SynthesisBMC medicine2018
Ethnic inequalities and pathways to care in psychosis in England: a systematic review and meta-analysis.
Synthesis in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The qualitative accounts of black informal carers of people with psychosis and their experiences accessing mental health services: a systematic review.Archives of public health = Archives belges de sante publique · 2025Pooled it
- Identifying evidence of the effectiveness of photovoice: a systematic review and meta-analysis of the international healthcare literature.Journal of public health (Oxford, England) · 2022Pooled it
- The effectiveness of adapted psychological interventions for people from ethnic minority groups: A systematic review and conceptual typology.Clinical psychology review · 2021Pooled it
- Clinical and social factors associated with involuntary psychiatric hospitalisation in children and adolescents: a systematic review, meta-analysis, and narrative synthesis.The Lancet. Child & adolescent health · 2021Pooled it
- Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses.Social psychiatry and psychiatric epidemiology · 2019Pooled it
- Predictors of engagement with peer support: analysis of data from a randomised controlled trial of one-to-one peer support for discharge from inpatient psychiatric care.The International journal of social psychiatry · 2023Trial
- Peer support for discharge from inpatient mental health care versus care as usual in England (ENRICH): a parallel, two-group, individually randomised controlled trial.The lancet. Psychiatry · 2022Trial
- A Critical Literature Review of Health Inequalities, Cultural Exclusion, and the Case for a Culturally Appropriate Digital Health Promotion App for Black Communities in England.Healthcare (Basel, Switzerland) · 2026Review
- Who Gets FIp? Understanding Contextual Factors in EIP Provision.Early intervention in psychiatry · 2026Article
- Ethnic minority carers' experiences of in-patient mental healthcare: qualitative study.BJPsych open · 2026Article
- From early intervention in psychosis to intensive care: correlates of restrictive psychiatric practice in a national retrospective cohort study.The British journal of psychiatry : the journal of mental science · 2026Article
- Article
- Reducing ethnic inequalities in experiences and outcomes of mental illness: A realist informed national programme evaluation.PLOS mental health · 2026Article
- What is the perception of treatment in some European mental health services? The point of view of users belonging to ethnic minorities.Frontiers in psychology · 2026Review
- Factors that affect pathways to care for youth with psychotic disorders in Newfoundland and Labrador, Canada: A qualitative study.PLOS mental health · 2026Article
- Interrelationships of long-term changes in recovery domains among patients with schizophrenia spectrum disorders: a six-year follow-up study.BMC psychiatry · 2025Article
- Which Sociodemographic and Pathway to Care Factors Influence the Wait Time for Early Intervention for Psychosis? A Mental Health Electronic Health Records Analysis in South London.Early intervention in psychiatry · 2025Article
- Ethnicity and involuntary hospitalisation: a study of intersectional effects.Social psychiatry and psychiatric epidemiology · 2025Article
- Racialised experience of detention under the Mental Health Act: a photovoice investigation.BMJ mental health · 2025Article
- Understanding the intersections between ethnicity, area-level deprivation, and inpatient-related features amongst patients with psychotic disorders: a mental health electronic records analysis.Social psychiatry and psychiatric epidemiology · 2025Article
10 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
Abstract
backgroundAs part of a national programme to tackle ethnic inequalities, we conducted a systematic review and meta-analysis of research on ethnic inequalities in pathways to care for adults with psychosis living in England and/or Wales.
methodsNine databases were searched from inception to 03.07.17 for previous systematic reviews, including forward and backward citation tracking and a PROSPERO search to identify ongoing reviews. We then carried forward relevant primary studies from included reviews (with the latest meta-analyses reporting on research up to 2012), supplemented by a search on 18.10.17 in MEDLINE, Embase, PsycINFO and CINAHL for primary studies between 2012 and 2017 that had not been covered by previous meta-analyses.
resultsForty studies, all conducted in England, were included for our updated meta-analyses on pathways to care. Relative to the White reference group, elevated rates of civil detentions were found for Black Caribbean (OR = 3.43, 95% CI = 2.68 to 4.40, n = 18), Black African (OR = 3.11, 95% CI = 2.40 to 4.02, n = 6), and South Asian patients (OR = 1.50, 95% CI 1.07 to 2.12, n = 10). Analyses of each Mental Health Act section revealed significantly higher rates for Black people under (civil) Section 2 (OR = 1.53, 95% CI = 1.11 to 2.11, n = 3). Rates in repeat admissions were significantly higher than in first admission for South Asian patients (between-group difference p < 0.01). Some ethnic groups had more police contact (Black African OR = 3.60, 95% CI = 2.15 to 6.05, n = 2; Black Caribbean OR = 2.64, 95% CI = 1.88 to 3.72, n = 8) and criminal justice system involvement (Black Caribbean OR = 2.76, 95% CI = 2.02 to 3.78, n = 5; Black African OR = 1.92, 95% CI = 1.32 to 2.78, n = 3). The White Other patients also showed greater police and criminal justice system involvement than White British patients (OR = 1.49, 95% CI = 1.03 to 2.15, n = 4). General practitioner involvement was less likely for Black than the White reference group. No significant variations over time were found across all the main outcomes.
conclusionsOur updated meta-analyses reveal persisting but not significantly worsening patterns of ethnic inequalities in pathways to psychiatric care, particularly affecting Black groups. This provides a comprehensive evidence base from which to inform policy and practice amidst a prospective Mental Health Act reform.
trial registrationCRD42017071663.
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