Ethnic Profile of Patients Discharged From a First Episode Psychosis Service in Derby City and South County

TL;DR

This study compares the ethnic makeup of patients discharged from a psychosis service in Derby City and South County with local census data, revealing significant ethnic disparities.

Contribution

The study provides new empirical evidence on ethnic disparities in access to early psychosis services in two distinct regions.

Findings

In Derby City, Asian and Black patients were over-represented in discharges compared to census data, while White patients were under-represented.

In Derbyshire South County, Asian and Black patients were also over-represented, and White patients were significantly under-represented.

Other ethnic groups were absent in both regions despite their presence in the census data.

Abstract

Aims: The Early Intervention for Psychosis (EIP) service in Derby City and Derbyshire South County provides care for individuals aged 14–65 experiencing a first episode of psychosis. Derby City (Census 2021 population: 261,400) is ethnically diverse, with White residents forming 73.8%, Asian residents 18.1% (including mixed White/Asian, and Arab), and Black residents 6.1% (including White and Black Caribbean, mixed White/Black, and African). In contrast, Derbyshire South County (Census 2021 population: 349,000) has a predominantly White population (95.2%), with Asian residents at 2.8%, Black residents at 1.4%, and other ethnic groups at 0.5%.

Aim was to ascertain the ethnic profile of patients discharged from the EIP service in Derby City and Derbyshire South County, comparing these findings with respective census data.

Methods: All patients discharged from the EIP service between 1 April 2023 and 1 April 2024, who were under the service for more than 3 months and typically not more than 3 years, were included. Data on ethnicity was retrospectively collected from clinical records, recorded in an Excel spreadsheet, and analysed to identify disparities compared with census demographics.

Results: In Derby City, White patients were under-represented at 60.87% compared with 73.8% in the census. Asian patients were over-represented at 21.74% versus 18.1%, and Black patients accounted for 17.39% of discharges compared with 6.1%. Other ethnic groups were absent (0%) compared with 2.0% in the census.

In Derbyshire South County, White patients represented 61.36% of discharges, lower than 95.2% in the census. Asian patients were over-represented at 27.27% compared with 2.8%, and Black patients at 11.36% versus 1.4%. No representation was observed from other ethnic groups, despite a 0.5% census presence.

Conclusion: The study highlights disparities in the ethnic profile of discharged EIP patients. Asian and Black populations were consistently over-represented, while White populations were under-represented, especially in Derbyshire South County. The absence of other ethnic groups raises concerns about service access. Further investigation is needed to explore factors such as socio-economic influences, cultural perceptions of mental health, referral pathways, and potential systemic biases.