Enhancing pathways to care for black and minority ethnic populations: a systematic review.

BACKGROUND: Improving pathways to care is an important part of UK Government policy on delivering equitable treatment for black and minority ethnic (BME) patients. However, there is little guidance on how this can be achieved. This systematic review aimed to evaluate research studies reporting initiatives to enhance pathways to mental health care for BME groups. METHODS: A review of published English language literature of studies reporting an evaluated intervention that aimed to enhance care pathways for BME communities or that achieved this as a by-product. Data extracted included the type of pathway improved, samples characteristics, type of intervention and outcome. RESULTS: Six studies met inclusion criteria. In only one was the initiative UK based. There was evidence that interventions led to three types of pathways change; accelerated transit through care pathways, removal of adverse pathways, and the addition of a beneficial pathway. Ethnic matching promoted desired pathways in many groups but not African Americans, managed care improved equity a pre-treatment service improved access to detoxification and an education leaflet increased recovery. CONCLUSION: Only a small number of papers satisfied the review criteria. Consequently, there is currently a dearth of information on which to build evidence-based guidance for service development. Evidence that is available is mainly not from the UK and hence needs to be treated with caution.