Ethnic inequalities in mortality and service use in people with mental disorders and multi-morbidities during the COVID-19 pandemic

There are stark inequalities in the UK mental health care system for people from minority ethnic groups, including poorer access to evidence-based treatments and higher rates of detention. Life expectancy in people with mental disorders is 15 to 20 years lower than the general population, mostly due to preventable long-term physical health conditions - and this is also seen in minority ethnic groups. The COVID-19 pandemic has magnified these inequalities, with an alarming trend towards higher COVID-19 infections and mortality in minority ethnic groups. Research by King's College London indicates higher rates of death during the UK lockdown in people with mental disorders. The pandemic has led to some routine health care being suspended, people being discharged from secondary care and care being delivered remotely. This, alongside people staying away from hospital, may have contributed to higher numbers of deaths in people with mental disorders, possibly with disproportionate impacts on people from minority ethnic groups. This research project will involve analysing more than 50,000 records from primary and secondary mental health care to assess whether changes to services as a result of COVID-19 magnified inequalities in care pathways, and whether it was associated with more deaths in people with mental disorders and long-term conditions. With the support of Black Thrive, a partnership for Black wellbeing, 50 interviews will be held with mental health service users across London, Birmingham and Manchester to understand their perspectives. All recommendations resulting from the research will be co-produced with people with lived experience, informing health care delivery and improving patient safety, as the pandemic continues.