Kolvenbach Sarah, Fernández de la Cruz Lorena, Mataix-Cols David, Patel Natasha, Jassi Amita
Division of Health Policy and Management, School of Public Health, University of Minnesota, Delaware Street, Minneapolis, MN, 55455, USA.
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.
Child Adolesc Ment Health. 2018 May;23(2):99-106. doi: 10.1111/camh.12197. Epub 2016 Oct 26.
Patients from ethnic minority backgrounds are underrepresented in clinical settings. Factors like cost of treatment, poor knowledge of the health system, geographic availability of services, lack of mental health literacy, differences in health beliefs, and social barriers have been identified as reasons for these inequalities. The aim of this study was to identify and compare barriers that parents from different ethnic groups face when accessing specialist services for obsessive-compulsive disorder (OCD) for their children.
Ten parents from White backgrounds and 10 from ethnic minority backgrounds were recruited from the National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, London, United Kingdom. They were interviewed about their opinions and experiences when accessing treatment.
Using thematic analysis, several common barriers for both groups were identified. These included a lack of knowledge of OCD, lack of resources within the health system, previous negative experiences, lack of trust in the mental health system, lack of time and financial issues, no support out of hours, bullying, and inconvenient location of services. In addition, there were several barriers that were endorsed by ethnic minority groups but not by the parents from White backgrounds, namely stigma and discrimination from within their communities, shame and denial, a general lack of trust in the health system by their cultural group, different beliefs about mental health issues, and discrimination from within the system.
Policy-makers and clinicians should be aware of the additional barriers minority patients may face in accessing treatment and should support interventions designed to overcome them.
在临床环境中，来自少数族裔背景的患者代表不足。治疗费用、对医疗系统了解不足、服务的地理可及性、缺乏心理健康素养、健康观念差异以及社会障碍等因素已被确定为这些不平等现象的原因。本研究的目的是识别和比较不同族裔的父母在为其子女获取强迫症（OCD）专科服务时所面临的障碍。
从英国伦敦的国家和青少年专科强迫症、躯体变形障碍及相关疾病诊所招募了10名白人背景的父母和10名少数族裔背景的父母。就他们在接受治疗时的意见和经历进行了访谈。
通过主题分析，确定了两组的几个共同障碍。这些障碍包括对强迫症缺乏了解、医疗系统内资源不足、既往负面经历、对心理健康系统缺乏信任、缺乏时间和资金问题、非工作时间无支持、欺凌以及服务地点不便。此外，少数族裔群体认可了一些白人背景的父母未提及的障碍，即来自其社区的耻辱感和歧视、羞耻感和否认、其文化群体对医疗系统普遍缺乏信任、对心理健康问题的不同信念以及来自系统内部的歧视。
政策制定者和临床医生应意识到少数族裔患者在获取治疗时可能面临的额外障碍，并应支持旨在克服这些障碍的干预措施。
