Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services
IntroductionTimely 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...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1469439/full |
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| author | Chenai Mandangu Anne Millicent Ramos Mohona Sengupta Rosslyn Bender Reem El-Hayani Ifrah Hasan Hannah Okechukwu Shafeena Anas Dominik Havsteen-Franklin |
| author_facet | Chenai Mandangu Anne Millicent Ramos Mohona Sengupta Rosslyn Bender Reem El-Hayani Ifrah Hasan Hannah Okechukwu Shafeena Anas Dominik Havsteen-Franklin |
| author_sort | Chenai Mandangu |
| collection | DOAJ |
| description | IntroductionTimely 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.MethodsA 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.ResultsThe 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.DiscussionFindings 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. |
| format | Article |
| id | doaj-art-26744de1674d4a1a986290d15a28a185 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-26744de1674d4a1a986290d15a28a1852025-02-07T05:10:35ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011210.3389/fpubh.2024.14694391469439Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health servicesChenai Mandangu0Anne Millicent Ramos1Mohona Sengupta2Rosslyn Bender3Reem El-Hayani4Ifrah Hasan5Hannah Okechukwu6Shafeena Anas7Dominik Havsteen-Franklin8Faculty of Medicine, Imperial College London, London, United KingdomFaculty of Medicine, Imperial College London, London, United KingdomFaculty of Medicine, Imperial College London, London, United KingdomKCW Arts Psychotherapies Service, CNWL NHS Foundation Trust, London, United KingdomFaculty of Medicine, Imperial College London, London, United KingdomFaculty of Medicine, Imperial College London, London, United KingdomFaculty of Medicine, Imperial College London, London, United KingdomTeam Based Learning and Education, Medical School, Brunel University of London, Uxbridge, United KingdomArts and Humanities, Brunel University of London, Uxbridge, United KingdomIntroductionTimely 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.MethodsA 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.ResultsThe 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.DiscussionFindings 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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1469439/fullthematic reviewimplicit biasindirect discriminationhealthcarepsychiatryinfluence mapping |
| spellingShingle | Chenai Mandangu Anne Millicent Ramos Mohona Sengupta Rosslyn Bender Reem El-Hayani Ifrah Hasan Hannah Okechukwu Shafeena Anas Dominik Havsteen-Franklin Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services Frontiers in Public Health thematic review implicit bias indirect discrimination healthcare psychiatry influence mapping |
| title | Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services |
| title_full | Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services |
| title_fullStr | Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services |
| title_full_unstemmed | Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services |
| title_short | Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services |
| title_sort | implicit bias in referrals to relational psychological therapies review and recommendations for mental health services |
| topic | thematic review implicit bias indirect discrimination healthcare psychiatry influence mapping |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1469439/full |
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