Experiences of children and young people from ethnic minorities in accessing mental health care and support: rapid scoping review

Abstract

Background Mental health problems are common among children and young people in the UK. They are experienced in different ways for some young people from ethnic minority backgrounds. Furthermore, those from ethnic minority backgrounds often have greater difficulties accessing mental health support, variable levels of engagement with services, and may prefer different support to their White British peers. Objective To describe the nature and scope of qualitative research about the experiences of children and young people from ethnic minority backgrounds in seeking or obtaining care or support for mental health problems. Data sources We searched seven bibliographic databases (ASSIA, CINAHL, MEDLINE, PsycInfo, HMIC, Social Policy and Practice, and Web of Science) using relevant terms [23 June 2021]. Methods The scoping review included qualitative research about young people’s experiences of seeking or engaging with services or support for mental health problems. Included studies were: published from 2012 onwards, from the UK, were about those aged 10 to 24 years and were from ethnic minority backgrounds (i.e. not White British). Study selection, data extraction and quality assessment (with ‘Wallace’ criteria) were conducted by two reviewers. We provide a descriptive summary of the aims, scope, sample, methods and quality of the included studies, and selected presentation of authors’ findings (i.e. no formal synthesis). Findings From 5335 unique search records, we included 26 papers or reports describing 22 diverse qualitative studies. Most of the studies were well conducted and clearly described. There were studies of refugees/asylum seekers (5 studies), university students (4), and studies among young people experiencing particular mental health problems (14; some studies appear in multiple categories): schizophrenia or psychosis (3), eating disorders (3), post-traumatic stress disorder (3; in asylum seekers), substance misuse (2) self-harm (2), and obsessive compulsive disorder (1). There were also three studies in ethnic minority young people who were receiving particular treatments (CBT, multi-systemic therapy for families, and a culturally adapted family-based talking therapy). Most studies had been conducted with young people or their parents from a range of different ethnic backgrounds. However, nine studies were conducted in particular ethnic groups: asylum-seekers from Afghanistan (2), Black and South Asian (2), Black African and Black-Caribbean (2), South Asian (1), Pakistani or Bangladeshi (1), and Orthodox Jewish (1). The studies suggested a range of factors that influence care-seeking and access to mental health care, in terms of the beliefs and knowledge of young people and their parents, the design and promotion of services, and the characteristics of care professionals. Poor access was attributed to a lack of understanding of mental health problems, lack of information about services, lack of trust in care professionals, social stigma, and cultural expectations about mental resilience. Limitations As a rapid scoping review there was only basic synthesis of the research findings. Future work Future research about young people from ethnic minorities could cover a wider range of ethnic minorities, sample and analyse separately experiences from particular ethnic minorities, cover those accessing different services for different needs, and adopt multiple perspectives (e.g. service user, carer, clinician, service management). Review protocol was pre-registered with Open Science Framework at: https://osf.io/wa7bf/