Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these.

To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare.

A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts.

Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities.

During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups’ engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.

精神卫生保健领域长期存在种族不平等。 COVID-19 大流行扩大了这些范围。

探讨利益相关者对 COVID-19 大流行如何加剧精神卫生保健方面种族不平等的看法。

对英格兰四个地区进行的定性访谈研究，涉及来自国家卫生服务 (NHS) 和社区组织的 34 名患者、15 名护理人员和 39 名心理健康专业人员（2021 年 7 月至 2022 年 7 月）。框架分析用于开发大流行前障碍与 COVID-19 影响之间相互关系的逻辑模型。

各个站点的影响基本相似，但存在一些细微的差异（例如，区域 2 中较高种族多样性的积极服务影响）。个人层面上的大流行前障碍包括不信任，从而避免服务；服务层面上的障碍包括单一文化模式占主导地位，导致沟通不畅、脱离和疏远。在大流行期间提供远程服务，社区组织的关闭和媒体的替罪羊加剧了现有的障碍，加剧了疏远和沟通障碍，助长了偏见和分裂，并增加了对服务的不信任。一些少数民族患者报告了积极的进展，通过自决和创造性活动体验到赋权。

在 COVID-19 大流行期间，一些患者表现出了韧性并形成了可以通过服务培养的适应能力。然而，社区中针对特定群体的 NHS 和第三部门服务的可用性有所减少，加剧了先前存在的障碍。由于这些发展可能会对少数族裔群体参与精神卫生保健产生长期影响，因此 NHS 及其合作伙伴需要优先解决这些问题。