Differences in psychological treatment outcomes by ethnicity and gender: an analysis of individual patient data
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Authors
Arundell, Laura-Louise
Saunders, Rob
Buckman, Joshua E. J.
Lewis, Glyn
Stott, Joshua
Singh, Satwant
Jena, Renuka
Naqvi, Syed Ali
Leibowitz, Judy
Pilling, Stephen
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Issue Date
01/09/2024
Type
Journal article
Language
Keywords
Mental Health
Alternative Title
Abstract
Purpose
There are discrepancies in mental health treatment outcomes between ethnic groups, which may differ between genders. NHS Talking Therapies for anxiety and depression provide evidence-based psychological therapies for common mental disorders. This study examines the intersection between ethnicity and gender as factors associated with psychological treatment outcomes. Aims were to explore by gender: (1) differences in psychological treatment outcomes for minoritized ethnic people compared to White-British people, (2) whether differences are observed when controlling for clinical and socio-demographic factors associated with outcomes, and (3) whether organization-level factors moderate differences in outcomes between ethnic groups.
Methods
Patient data from eight NHS Talking Therapies for anxiety and depression services ( n = 98,063) was used to explore associations between ethnicity and outcomes, using logistic regression. Stratified subsamples were used to separately explore factors associated with outcomes for males and females.
Results
In adjusted analyses, Asian (OR = 0.82 [95% CI 0.78; 0.87], p < .001, 'Other' (OR = 0.79 [95%CI 0.72-0.87], p < .001) and White-other (0.93 [95%CI 0.89-0.97], p < .001) ethnic groups were less likely to reliably recover than White-British people. Asian (OR = 1.48 [95% CI 1.35-1.62], p < .001), Mixed (OR = 1.18 [95% CI 1.05-1.34], p = .008), 'Other' (OR = 1.60 [95% CI 1.38-1.84], p < .001) and White-other (OR = 1.18 [95% CI 1.09-1.28], p < .001) groups were more likely to experience a reliable deterioration in symptoms. Poorer outcomes for these groups were consistent across genders. There was some evidence of interactions between ethnic groups and organization-level factors impacting outcomes, but findings were limited.
Conclusions
Across genders, Asian, 'Other' and White-other groups experienced worse treatment outcomes across several measures in adjusted models. Reducing waiting times or offering more treatment sessions might lead to increased engagement and reduced drop-out for some patient groups.
Description
Citation
Soc Psychiatry Psychiatr Epidemiol 59, 1519–1531 (2024). https://doi.org/10.1007/s00127-024-02610-8
Publisher
License
Journal
Social Psychiatry and Psychiatric Epidemiology
Volume
59
Issue
9