Unintentional Discrimination Against Patients with a Migration Background by General Practitioners in Mental Health Management: An Experimental Study

Populations with a migration background have a higher prevalence of mental health problems than their native counterparts. They are also more likely to have unmet medical needs and are less frequently referred to mental health services. One potential explanation for this is that physicians, such as...

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Published in:Administration and policy in mental health and mental health services research 2023-05, Vol.50 (3), p.450-460
Main Authors: Duveau, Camille, Wets, Camille, Delaruelle, Katrijn, Demoulin, Stéphanie, Dauvrin, Marie, Lepièce, Brice, Ceuterick, Melissa, De Maesschalck, Stéphanie, Bracke, Piet, Lorant, Vincent
Format: Article
Language:English
Subjects:
Belgium
Clinical Psychology
Discrimination
Disease management
Ethnic differences
Factorial experiments
Family physicians
General Practitioners - psychology
Health Administration
Health Informatics
Health needs
Health problems
Humanization
Humans
Life history
Medical decision making
Medical diagnosis
Medical referrals
Medicine
Medicine & Public Health
Mental depression
Mental disorders
Mental Health
Mental health care
Mental health professionals
Mental health services
Migrants
Migration
Needs assessment
Original
Patients
Physicians
Primary care
Psychiatry
Public Health
Racial differences
Referral and Consultation
Treatment methods
Variance analysis
Vignettes
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Summary:Populations with a migration background have a higher prevalence of mental health problems than their native counterparts. They are also more likely to have unmet medical needs and are less frequently referred to mental health services. One potential explanation for this is that physicians, such as general practitioners (GPs), may unintentionally discriminate against migrant patients, particularly when they lack humanization. To date, no experimental study has investigated this hypothesis. This paper assesses the influence of humanization on GPs’ discriminatory decisions regarding migrant patients with depression. A balanced 2 × 2 factorial experiment was carried out with Belgian GPs (N = 797) who received video-vignettes depicting either a native patient or a migrant patient with depression. Half of the respondents were exposed to a text that humanized the patient by providing more details about the patient’s life story. Decisions related to diagnosis, treatment and referral were collected, as well as the time spent on each video and text, and were analysed using ANOVA. Migrant patients’ symptoms were judged to be less severe than those of native patients (F = 7.71, p 
ISSN:0894-587X
1573-3289
DOI:10.1007/s10488-023-01250-5