Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review
Please note: this is a legacy publication from CPEC (formely PSSRU at LSE).British Journal of Psychiatry 207 2 95-103
Available online: 3 August 2015
Background
Communication may be an influential determinant of
inequality of access to, engagement with and benefit from
psychiatric services.
To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services.
Method
Systematic review and evidence synthesis (PROSPERO
registration: CRD42011001661). Data sources included the
published and the ‘grey’ literature. A survey of experts and a
consultation with patients and carers all contributed to the
evidence synthesis, interpretation and recommendations.
Results
Twenty-one studies were included in our analysis. The trials
showed benefits mainly for depressive symptoms,
experiences of care, knowledge, stigma, adherence to
prescribed medication, insight and alliance. The effect sizes
were smaller for better-quality trials (range of d 0.18–0.75)
than for moderate- or lower-quality studies (range of d
0.18–4.3). The review found only two studies offering weak
economic evidence.
Conclusions
Culturally adapted psychotherapies, and ethnographic and
motivational assessment leading to psychotherapies were
effective and favoured by patients and carers. Further trials
are needed from outside of the UK and USA, as are
economic evaluations and studies of routine psychiatric care
practices.