Ethnic differences in reported unmet needs among male inpatients with severe mental illness

ACCESSIBLE SUMMARY: ? Literature suggests that ethnic minority groups are disadvantaged within current health care services in the UK. This study attempts to identify the rates and nature of unmet health and social needs across three ethnic groups. ? Inpatients of African ethnicity reported significantly less unmet needs than their White British counterparts. ? Unmet needs in the domains of psychotic symptoms, alcohol use and safety to self differed significantly across the three ethnic groups. ? Inpatients of White British heritage appeared to have more unmet needs and/or were more willing to disclose these compared to other ethnic groups. ? The ability to meet health and social needs is complicated by the presence of antisocial personality disorder and alcohol dependence. ABSTRACT: Health services are failing to meet the needs of ethnic minority groups with severe mental illness in the UK. Understanding these unmet social and health needs will assist service providers in developing culturally sensitive and responsive care pathways. Using a cross-sectional design, 165 service users were recruited from 10 acute inpatient wards across four South London boroughs. Needs were assessed using the Camberwell Assessment of Need Short Assessment Schedule and substance dependence and antisocial personality disorder were measured using the Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test and the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders. African, but not African-Caribbean, heritage continued to predict lower rates of reported unmet needs compared to White British (P < 0.001) following multivariate analysis. Different patterns of unmet needs were observed across ethnic heritage groups. Antisocial personality disorder and alcohol dependence were also independently associated with unmet needs. Consideration of a patient's ethnic identity and comorbidities is essential for effective needs assessment within psychiatric and mental health nursing.