A rapid review of the effectiveness of interventions to enhance equitable or overall access to mental health services by ethnic minority groups

It is estimated that one in four people will experience poor mental health throughout their lifetime. However, ethnic minority groups, refugees and asylum seekers experience more barriers accessing mental health services and have poorer mental health outcomes than those from non-ethnic minority groups. Evidence suggests that interventions that improve access and engagement with mental health services may help reduce disparities affecting ethnic minority groups. This review aims to assess the effectiveness of interventions that enhance equitable or overall access to mental health services by ethnic minority groups. The review included evidence available up until 19th December 2023. Psycho-educational interventions that focused on providing culturally appropriate information, showed mixed results for help seeking behaviour, improvements in depressions stigma. Multi-component interventions within healthcare settings had mixed results. Some studies showed positive outcomes; such as increased help seeking intentions and improved attendance rates, while others did not show significant differences in outcomes. Interventions that included integrating specialist mental health services within primary care resulted in variable outcomes. The findings of interventions incorporating language support into mental health services were also variable. The effectiveness of interventions to enhance the cultural competency of mental health services varied across studies. Research Implications and Evidence Gaps Future research should prioritise rigorous study designs, including randomised controlled trials and longitudinal studies. More research is required to compare outcomes between ethnic minority participants and White participants. Economic considerations Ethnic minority individuals are disproportionately affected by economic determinants of poor mental health including increased likelihood of low income. Future research should investigate the economic benefit from an NHS and societal perspective of improving access to mental health services for ethnic minority individuals. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The Wales Centre for Evidence Based Care, the Specialist Unit for Review Evidence for Health Economics, and the Centre for Health Economics and Medicines Evaluation were funded for this work by the Health and Care Research Wales Evidence Centre, itself funded by Health and Care Research Wales on behalf of Welsh Government ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * aOR : Adjusted Odds Ratio aHR : Adjusted Hazard Ratio aIRR : Adjusted Incident Rate Ratio CAMHS : Child and Adolescent Mental Health Services CG : Control group CI : Confidence interval GP : General practitioner IAPT : Improving Access to Psychological Therapy IG : Intervention group IRR : Incident Rate Ratio OR : Odds Ratio QCC : Quality Criteria Checklist RCT : Randomised Controlled Trial SD : Standard Deviation SE : Standard Error