Demographic Characteristics of Adolescents Referred for Psychoanalytic Psychotherapy – Who Is Being Left Out?

• Published in: BJPsych open Vol. 9; no. S1; p. S139
• Main Authors: Pietrogrande, Erica, Strzelczak, Agnieszka
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.07.2023
• Subjects: Censuses; Chi-square test; Ethnicity; Poster Presentations; Psychotherapy; Service Evaluation; Transgender persons; Young adults
• ISSN: 2056-4724; 2056-4724
• DOI: 10.1192/bjo.2023.382

Aims In response to the growing awareness of health inequalities in the UK, institutions are called to take responsibility in tackling obstacles to equality, diversity and inclusion to mental health services access. This study aims to evaluate the demographic profile of referrals from London borough of Camden residents (aged 18 to 25 years) to the Tavistock Adolescents and Young Adults Service (AYAS) for psychodynamic psychotherapy. We aim to evaluate whether the demographic characteristics of referrals were a good representation of the local population. Methods Age, gender, and ethnicity of Camden AYAS referrals received between 12th April and 14th December 2021 (n=38, age range 17 to 24 years) were collected retrospectively using the electronic patient record system and compared with the following age groups of the latest Camden Census data (2011): 16-17, 18-19 and 20-24 years. The two sets of data were analysed using Chi-Square goodness of fit test. Results Females were significantly overrepresented among AYAS referrals compared to Camden population (86.5% vs 52.8%, X2=16.83, p=.001). No conclusion could be reached regarding transgender individuals due to lack of data about transgender population in 2011 Census data. Ethnicity was recorded in n=33 referrals and evaluated at group and subgroup level, utilising standardised categorisation. We found that the proportions of five main ethnic categories differed significantly between the AYAS and Census groups, (X2=13.07, p=.05). In the AYAS referrals Mixed ethnicity group was over 3 times higher than expected based on Census data, while the Asian group was markedly underrepresented. Significant disproportions were also identified at ethnic subcategory level (X2=39.98, p=.01). No one of Asian-Bangladeshi or Asian-Chinese ethnicity was referred to AYAS in the timeframe considered. People of Black ethnicity were represented as expected overall with all referrals (n=3) identifying as Black-African. Although overall White ethnicity was represented as expected, White-British were underrepresented (18.2% vs 39.2%) with majority of referrals identifying as other White ethnic subcategories (36.4% vs 15.5%). Conclusion Limitations of this study include sample size, outdated Census data and limitations of statistical tests used. Our findings indicate males are under-referred to the AYAS psychotherapy service together with some ethnic minorities (Asian overall, and in particular Asian-Chinese and Asian-Bangladeshi). This may be due to unconscious bias in the referral process. Further exploration is needed to understand underlying causes so that effective strategies to promote equality in access to services can be implemented.