Ethnic mental health inequalities: Understanding whether discrimination causes psychosis among people from ethnic minority backgrounds
Why is this study important?
Psychosis causes considerable suffering, affecting around 3% of the global population at some point in lives. Despite recent advancements in treatment, only a few as <14% individuals diagnosed with psychosis achieve sustained clinical and social recovery, leading to substantial financial costs, exceeding £29.1 billion per year in the UK alone. Critically, ethnic minority populations are disproportionately affected by psychosis and experience higher levels of discrimination compared to ethnic majority groups. For example, the incidence rate of psychosis is significantly elevated among people from African-Caribbean backgrounds (7x), Black African (4x), Asian (3x), and White non-British (1.5x) compared to White Britons in the UK. Therefore, it is essential to understand why rates are significantly high among these populations. Evidence suggests that discrimination and marginalisation play a role in the development of psychotic symptoms in ethnic minority populations, but research in this area is limited.
Therefore, the aims and objectives of this study are as follows:
Aims:
This study aims to understand the causal relationship between discrimination and psychosis in ethnic minority populations in the UK.
Objectives:
- Explore if the content of people's psychotic thoughts is related to discrimination and if discrimination is linked to symptom onset.
- Investigate if there is a causal relationship between ethnic discrimination and symptoms of psychosis.
- Investigate whether ethnic identities exacerbate or protect against the effects of discrimination on psychosis.
What will be the methodology?
Stream 1 - Qualitative Interviews
Qualitative interviews will be conducted with patients diagnosed with psychosis/schizophrenia from ethnic minority backgrounds in the UK. The interviews will explore the impact of ethnic discrimination on symptoms of psychosis, the content of paranoid thoughts and hallucinations, and the antecedents of initial symptoms. Participants will be recruited through social media and with the support of community organisations.
Stream 2 - Prospective Cohort Study
Data on experiences of discrimination, ethnic identities, and symptoms of psychosis will be collected from people from ethnic minority backgrounds (n=250) and White Britons (n=250) at baseline, 6-month, 12-month, and 18-month follow-up assessments.
Stream 3 - Surveys
Study 3A will involve secondary data analysis of a dataset which includes African and African Caribbean participants (N = 355) and validated measures of multiple psychosis symptoms (paranoia, dissociation, and hallucinations), as well as discrimination and ethnic identity.
Study 3B aims to replicate and extend the findings from Study 3A to other ethnic groups. A non-clinical sample of approximately 350 participants will be recruited, with emphasis on recruiting people from South Asian and Arab backgrounds.
Who is carrying out the study?
The study is funded and conducted at Liverpool John Moores University.
Who should I contact for more information about the study?
Principal Investigator: Rashmi Danwaththa Liyanage
Email: R.D.DanwaththaLiyanage@2023.ljmu.ac.uk
Director of Studies: Dr Jason McIntyre
Email: j.c.mcintyre@ljmu.ac.uk
Telephone: 0151 231 2121
Address: School of Psychology, 320, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF