Demographic Equality of Access to Cognitive Behavioural Treatment for Early Psychosis in Community Mental Healthcare in Greater London

Individuals experiencing psychosis have been described as one of the most stigmatised, disadvantaged and socially excluded groups in modern societies. Despite the development of evidence-based psychological treatments for psychosis, the access to such intervention remains debateable. In metropolitan areas, where clinical caseloads of mental health services should reflect the ethnic diversity of local populations, equal provision of recommended therapies might be further confounded, while empirical literature investigating this appears limited. The present study inspects equality of access to cognitive behavioural therapy for psychosis across four specialist healthcare teams located in Greater London. Subsequent acceptance and participation in treatment are also examined. A retrospective analysis of electronic medical records of 244 patients was conducted using binary logistic regression and multiple linear regression. Participants were shown to have received treatment offers equally across demographic variables. Likewise, once the treatment commenced, engagement was equally distributed. However, despite having equal access to the offered treatment, patients of Black ethnic group seemed less likely to accept such offer, hence appeared disadvantaged in terms of treatment provision. This study demonstrates that, in multicultural communities, equal access to core interventions for psychosis is achievable, however does not on its own merits ensure equitable treatment provision. Thus mental health services need to proactively focus on specific ethnic groups requiring further efforts to increase treatment uptake. Keywords: mental health, psychosis, cognitive behavioural treatment, diversity, equal access to healthcare