Section of Women's Mental Health, Department of Health Services and Population Research, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park Road, London, SE5 8AZ, UK.
NIHR Specialist Mental Health Biomedical Research Centre (BRC) At South London and Maudsley NHS Foundation Trust, London, SE5 8AF, UK.
Soc Psychiatry Psychiatr Epidemiol. 2021 Nov;56(11):1943-1956. doi: 10.1007/s00127-021-02035-7. Epub 2021 Feb 16.
Common mental disorders (CMD), such as depression and anxiety, are an important cause of morbidity, economic burden and public mental health need. The UK Improving Access to Psychological Therapies (IAPT) programme is a national effort to reduce the burden and impact of CMD, available since 2008.
To examine ethnic and migration-related differences in use of IAPT-based psychological treatment using a novel epidemiological dataset with linkage to de-identified IAPT records.
Data from a psychiatric morbidity survey of two South East London boroughs (2008-2010) were individually-linked to data on IAPT services serving those boroughs. We used Poisson regression to estimate association between ethnicity and migration status (including years of UK residence), with rate of subsequent use of psychological treatment.
The rate of psychological treatment use was 14.4 cases per thousand person years [cases/1000 pyrs, 95% confidence intervals (95% CI) 12.4, 16.7]. There was strong statistical evidence that compared to non-migrants, migrants residing in the UK for less than 10 years were less likely to use psychological treatment after adjustment for probable sociodemographic predictors of need, life adversity, and physical/psychiatric morbidity at baseline [rate ratio (RR) 0.4 (95% CI 0.20, 0.75]. This difference was not explained by migration for asylum/political reasons, or English language proficiency, and was evident for both self- and GP referrals.
Lower use of IAPT among recent migrants is unexplained by sociodemographics, adversity, and baseline morbidity. Further research should focus on other individual-level and societal barriers to psychological treatment use among recent migrants to the UK, including in categories of intersecting migration and ethnicity.
常见精神障碍（CMD），如抑郁和焦虑，是发病率、经济负担和公共精神卫生需求的重要原因。英国改善心理治疗服务（IAPT）计划是自 2008 年以来为减轻 CMD 负担和影响而进行的全国性努力。
使用新的流行病学数据集并与 IAPT 记录进行链接，研究基于 IAPT 的心理治疗使用方面的种族和移民相关差异。
利用两个伦敦东南部行政区的精神病发病率调查（2008-2010 年）的数据，与为这些行政区提供的 IAPT 服务数据进行个体链接。我们使用泊松回归来估计种族和移民身份（包括在英国居住的年数）与随后使用心理治疗的比率之间的关联。
心理治疗使用率为每千人 14.4 例[病例/1000 人年，95%置信区间（95%CI）为 12.4，16.7]。经过调整，与非移民相比，在英国居住不到 10 年的移民在需要的可能社会人口预测因素、生活逆境以及基线时的身体/精神疾病负担后，使用心理治疗的可能性较低，调整后比率比（RR）为 0.4（95%CI 0.20，0.75）。这种差异不能用庇护/政治原因的移民或英语水平来解释，而且在自我和 GP 转诊中都很明显。
IAPT 在近期移民中的使用率较低，无法用社会人口统计学、逆境和基线发病率来解释。进一步的研究应侧重于英国近期移民在使用心理治疗方面的其他个体层面和社会障碍，包括交叉移民和种族类别。
