Ethnic Density And Psychosis, An Explorative Investigation Into The Elevated Psychosis Rates In Minority Ethnic Groups In The UK

The research scholarship covered the fourth year of a six-year part time PhD program I am undertaking at Lancaster University. This report provides a summary of my progress to date including the fourth year that is covered by the scholarship. The transition into the fourth year was preceded by successful completion of the taught phase and the fourth year marked the commencement of the research phase. The research is based on ethnic density, ethnicity and psychosis.

Background: There is extensive literature in the UK showing that there are elevated rates of psychotic disorders in the Black and Ethnic Minority (BME) population in the UK compared to the native population. These rates are in the BME as a combined group but are more noticeable in the black British/Black Caribbean/Black African population. This leads to disparities in the use of mental health services along ethnic categories. The issue of the disparities in mental health along ethnic classifications is topical as the government has attempted to address it using policy such as Delivering Race Equality (DRE) in mental health. The reasons behind these disparities including elevated psychotic rates are not known. Several possible explanations have been put forward including the ‘ethnic density effect’. The ethnic density effect seems to buffer or exacerbate psychotic disorders. However, how the ethnic density effect does this is not fully understand.

Aim: The aim of the research project is to try and understand how the ethnic density effect seems exacerbate psychotic disorders in low ethnic density areas. The research project will attempt to explore and propose a framework that will explain the mechanisms behind the ethnic density effect.

Methodology: A qualitative methodology will be used to explore the participants’ experience and perceptions towards getting a psychotic disorder in the community. Data collection and analysis will be done using Charmaz’s grounded theory approach. Face to face semi-structured interviews will be conducted with participants who have a clinical diagnosis of psychotic disorder.

Progress to date: At the end of the fourth year, I had successfully transitioned into the research phase. During the fourth year, I finalised the research protocol, completed the literature review, obtained National Health Service (NHS) ethics approval, gained access to NHS sites for recruitment and commenced recruiting participants.

To date, I have conducted nine interviews, I have transcribed them and analysis is on-going. The research is relevant to my role as a clinical nurse specialist in liaison psychiatry and as an aspiring academic. Providing new knowledge in the area will help in formulating evidence based public health strategies on the issue.  Developing research skills will empower me to look at other issues in mental health and lead in developing mental health services.

A favourable ethical opinion for this study was granted by the London-City & East Research Ethics Committee.

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