Ethnic Differences in Referral Routes to Youth Mental Health Services.

OBJECTIVE: To examine whether there are ethnic differences in referral route to youth mental health services.
METHOD: This was an analysis of national, routinely collected data from 14,588 young people (mean [SD] age = 12.28 [3.75] years, 54% female; 64% white British) accessing mental health services in the United Kingdom. Ethnicity was self-reported by young people and carers, and referral route was recorded by services.
RESULTS: After accounting for service-level variation and controlling for age, sex, problem type, and contextual factors, ethnicity was significantly associated with referral route. Compared to white British young people, black young people (odds ratio [OR] = 2.90, 95% CI = 2.07-4.06) and mixed-race young people (OR = 2.66, 95% CI = 1.91-3.72) were more than twice as likely to be referred through social care/youth justice than through primary care. Compared to white British young people, Asian young people (OR = 1.85, 95% CI = 1.34-2.54) were almost twice as likely to be referred through social care/youth justice than through primary care. We conducted a sensitivity analysis to examine whether ethnic differences in referral route were attenuated when also accounting for service area deprivation, and the above effects were only partially attenuated.
CONCLUSION: There are ethnic differences in referral route to youth mental health services in the United Kingdom, and young people from minority ethnic backgrounds are more likely to be referred through routes that are less likely to be voluntary. Understanding the reasons for these differences is critical for reducing inequalities and improving pathways to mental health care access.