What is the health problem?

There are stark inequalities in the UK mental health care system for people from minority ethnic groups, including poorer access to evidence-based treatments and higher rates of detention. Life expectancy in people with mental disorders is 15 to 20 years lower than the general population, mostly due to preventable long-term physical health conditions – and this is also seen in minority ethnic groups.

The Covid-19 pandemic has magnified these inequalities, with an alarming trend towards higher Covid-19 infections and mortality in minority ethnic groups. Research by applied informatics researchers at ARC South London identified higher rates of death during the UK lockdown in people with mental disorders.

The pandemic also led to some routine health care being suspended, people being discharged from secondary care and care being delivered remotely. This, alongside people staying away from hospital, may have contributed to higher numbers of deaths in people with mental disorders, possibly with disproportionate impacts on people from minority ethnic groups.

How the ARC is addressing these inequalities

A team of ARC researchers including applied informaticians and social scientists specialising in qualitative methods and health inequalities have initiated this research to understand inequalities in south London and to create recommendations to inform service delivery and care provision.

The project is led by Dr Jayati Das-Munshi, clinical reader, King’s College London and is in partnership with the University of Sussex and Black Thrive, a partnership for Black wellbeing. It uses a range of methods to assess inequalities, including analysis of large-scale electronic health records, and interviews with mental health service users.

Aims of this research

Using a mixed-methods approach, the research aims to:

  • Identify how the pandemic has impacted pre-existing inequalities (deaths, service use) in people with severe mental disorders
  • Understand experiences of physical health care and service access during the pandemic through interviews with service users and carers
  • Synthesise evidence and, working with service users and carers, generate actionable recommendations which may align with the national Patient and Carer Race Equality Framework

How the project is being carried out

The research team is analysing more than 50,000 records from primary and secondary mental health care to assess whether changes to services as a result of Covid-19 magnified inequalities in care pathways, and whether it was associated with more deaths in people with mental disorders and long-term conditions.

With the support of Black Thrive, 50 interviews have been held with mental health service users across London, Birmingham and Manchester to understand their perspectives. This qualitive side of the research is being led by Dr Josephine Ocloo, senior researcher and Health Foundation Improvement Science Fellow at King’s College London.

All recommendations resulting from the research will be co-produced with people with lived experience, informing health care delivery and improving patient safety.

This project is funded by The Health Foundation and is expected to finish in 2023.

Find out more