2 research outputs found
Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services
Get PDFData availability statement:
The dataset supporting this study is publicly available on Brunel University's Figshare repository. It can be accessed at the following link: https://doi.org/10.17633/rd.brunel.27332307.v2.Introduction: Timely and appropriate psychological treatment is an essential element required to address the growing burden of mental health issues, which has significant implications for individuals, society, and healthcare systems. However, research indicates that implicit biases among mental health professionals may influence referral decisions, potentially leading to disparities in access to relational psychological therapies. This study investigates bias in referral practices within mental health services, identifying key themes in referral procedures and proposing recommendations to mitigate bias and promote equitable access.
Methods: A systematic review of literature published between 2002 and 2022 was conducted, focusing on biases, referral practices, and relational psychological therapies. The search strategy involved full-text screening of studies meeting inclusion criteria, specifically those examining professional and organizational implicit bias in mental health referrals. Thematic synthesis was employed to analyze and categorize bias within these domains, providing a structured framework for understanding its impact on referral decision making processes.
Results: The search yielded 2,964 relevant papers, of which 77 underwent full-text screening. Ultimately, eight studies met the inclusion criteria and were incorporated into the review. The analysis revealed that bias development mechanisms in referral decisions occurred across five key domains: resource allocation, organizational procedures, clinical roles, decision-making, and referral preferences. These domains highlight organizational and practitioner-level factors contributing to disparities in access to psychological therapies.
Discussion: Findings suggest that implicit biases within referral processes can limit equitable access to psychological therapies, particularly relational therapies that emphasize therapeutic alliance and patient-centered care. This study provides recommendations to address these biases, including standardized referral guidelines, enhanced professional training on implicit bias, and improved oversight mechanisms within mental health services.The author(s) declare financial support was received for the research, authorship, and/or publication of this article. CNWL NHS Foundation Trust provided a grant to Brunel University of London
Parents’ concerns and understandings around excessive infant crying: qualitative study of discussions in online forums
Get PDFCrying is an essential behaviour in infants, occurring on a continuum, and only rarely indicates serious underlying diagnosis. Searching online for information about excessive crying has become common, using the internet to seek health information and support through forums. The aim of this study was to examine data systematically derived from discussion threads on two online parent forums to explore discussions around excessive infant crying. This study utilised two qualitative approaches; the first, a thematic analysis to explore concerns around excessive crying, and the second, discursive psychology, to explore how diagnostic labels (underlying medical cause of crying) are negotiated within an online thread. The thematic analysis identified a tension between interpreting what is ‘normal’ crying and when crying is a sign of an ‘underlying problem’ leading to a search for a diagnostic label. This tension seemed to be heightened when expectations that infancy should be a ‘happy time’ were threatened by excessive crying. Responses to original posts offered support for parents/caregivers to 'trust their instincts' and to explore different diagnostic labels. The discursive psychology analysis explored responders' accounts of their experiences to increase credibility and showcase expertise. Forums play an important social role, meeting needs for reassurance, validation, and empowerment. This study suggests that labels are used interchangeably, and further work is needed to understand how perceptions are developed and acted on in the community, as well as online. Furthermore, this study suggests there is a need for supporting parents/caregivers in understanding and managing common behaviours such as excessive crying
