Mental Health Practitioners' Recognition of Disordered Eating in White and South Asian Patients

Eating disorders are mostly prevalent in young females, with rates of disordered eating up to five times higher than diagnosable cases. There is evidence to suggest females from a South Asian background have higher rates of eating disorder symptomatology than their White counterparts. Culture plays a role in susceptibility to eating disorders, and factors such as parental control, stigma and ethnic stereotyping by health professionals can be additional barriers to seeking and receiving appropriate help. This thesis was concerned with the clinical decision-making processes of UK mental health practitioners and whether the ethnicity of clients affected this. Three vignettes were devised, one including clinical features indicative of a restrictive eating pattern, one of a binge eating pattern and one with depression and anxiety symptoms. Each vignette was presented with a picture of either a young Asian female or a White female. One hundred and fifty six participants, all clinical staff in IAPT services, filled in an online survey comprising of one vignette and a questionnaire exploring factors involved in clinical decision-making and potential barriers to engagement. Mental health practitioners were less likely to rate the vignette as showing symptoms of anorexia nervosa when the picture presented was that of an Asian female as opposed to a White female, and more likely to rate the Asian version with bulimia nervosa. There were no significant differences between ethnic groups in terms of treatment recommendations. Social and cultural factors were identified as areas of concern in the White vignette version, an unexpected finding. These findings indicate there may be ethnic bias present in decision-making regarding eating disorders and disordered eating patterns. It is recommended training in both identifying eating disorder symptomatology and cultural competency is emphasised more in training courses and beyond. Further research into decision-making by mental health providers is also needed