Kamaldeep Bhui

University of Oxford | OX · Department of Psychiatry

Background The current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services. Objective We undertook a detailed realist secondary qualitative analysis of 10 interviews in wh...

Background: Youth adversity is associated with persistence of depression and anxiety symptoms over time. Evidence suggests that this association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g., males). However, given that persistent symptoms are observed across a range of disadvantaged groups...

Background: Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little...

Background: Youth adversity (e.g., abuse and bullying victimisation) is robust risk factor for later mental health problems (e.g., depression and anxiety). Research shows the prevalence of youth adversity and rates of mental health problems vary by individual characteristics, identity or social groups (e.g., gender and ethnicity). However, little i...

Introduction Patients with borderline personality disorder are often a challenge to the mental health system. Psychiatrists see people with BPD as manipulative, difficult to manage, annoying, unlikely to arouse sympathy, clinicians hold negative attitude towards personality disorder. As the next generation of doctors, medical students’ perception o...

Background Long-standing ethnic inequalities in access and mental healthcare were worsened by the COVID-19 pandemic. Objectives Stakeholders coproduced local and national implementation plans to improve mental healthcare for people from minority ethnic groups. Methods Experience-based codesign conducted in four areas covered by National Health Se...

Aims As the next generation of doctors, medical students' perception of patients with personality disorder (PD) is critical. Yet a systematic review of the literature shows this has not been studied. The study aims to identify 1) the understanding and perception of medical students about PD and 2) factors that may relate to this knowledge and perce...

Background: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. Aims: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research...

Syndemic theory is described as population-level clustering or co-occurrence of health conditions in the context of shared aetiologies that interact and can act synergistically. These influences appear to act within specific places of high disadvantage. We suggest ethnic inequality in experiences and outcomes of multimorbidity, including psychosis,...

Editorial Independence is an essential principle in scientific publishing, protecting the content from undue influence beyond the scientific data. This involves assurances around research integrity, publications ethics, combatting undue influence from journal owners, and improving on research practices including peer review and declarations and man...

Objective: Despite calls to increase the 'cultural competence' of health care providers, racially minoritised people continue to experience a range of problems when it comes to health care, including discrimination. While relevant qualitative meta-syntheses have suggested better ways forward for health care for racialised minorities, many have lac...

Background Creative arts practice can enhance the depth and quality of mental health research by capturing and foregrounding participants’ lived experience. Creative methods are emotionally activating and promote multiple perspectives, tolerating ambiguities and uncertainties, which are shared and even celebrated. Key arguments Methods such as pho...

Background: Depression is common amongst patients receiving haemodialysis (HD). Assessment and intervention when faced with language and cultural barriers is challenging. To support clinician decisions, we conducted a cross-sectional study to assess the use of culturally adapted and translated versions of commonly-used depression screening questio...

In this paper, we describe a model of research practise that addresses epistemic injustice as a central objective, by valuing lived experience and addressing structural disadvantages. We set out here the processes we undertook, and the experiences of those involved in an attempt to transform research practise within a study known as Co-pact. We do...

The draft Mental Health Bill, which amends the Mental Health Act 1983 for England and Wales, proposes protections for people with intellectual disability and/or autism (ID/A) to prevent detention in hospital in the absence of mental illness. This editorial critically appraises the positive impact and unintended consequences of the proposed reforms...

Adverse childhood experiences (ACEs) can harm mental health across the lifespan and reduce life expectancy. We provide a commentary of evidence on the health impacts, and how creative arts and digital interventions may support prevention and recovery.

Background Studies show ethnic inequalities in rates of involuntary admission and types of clinical care (such as psychological therapies). However, few studies have investigated if there is a relationship between clinical care practices and ethnic inequalities in involuntary admission. Aims This study investigated the impact of ethnicity and clin...

Introduction Ethnic disparities in treatment with clozapine, the antipsychotic recommended for treatment-resistant schizophrenia (TRS), have been reported. However, these investigations frequently suffer from potential residual confounding. For example, few studies have restricted the analyses to TRS samples and none has controlled for benign ethni...

Introduction Studies have shown ethnic inequalities in health, with a higher incidence of illnesses among people of some minoritised ethnic groups. Furthermore, it has been observed that people with severe mental illnesses have a higher risk for multimorbidity. However, no study has investigated ethnic disparities in comorbidity in people with a sc...

Background Inflammation is a risk factor for chronic physical illnesses. Evidence is building that inflammation is also a risk factor for mental illnesses making inflammation a common mechanism which could explain the high comorbidity between mental and physical illnesses. Method Based on a systematic search, a review on factors associated with in...

Aims Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have an increased risk of multiple long-term conditions (MLTC; multimorbidity). However, there is limited research regarding ethnic inequities in multimorbidity in pe...

Purpose Clozapine is the most effective intervention for treatment-resistant schizophrenia (TRS). Several studies report ethnic disparities in clozapine treatment. However, few studies restrict analyses to TRS cohorts alone or address confounding by benign ethnic neutropenia. This study investigates ethnic equity in access to clozapine treatment fo...

Poor research integrity is increasingly recognised as a serious problem in science. We outline some evidence for this claim and introduce the Royal College of Psychiatrists (RCPsych) journals’ Research Integrity Group, which has been created to address this problem.

The Ukrainian refugee crisis highlights the many issues associated with trauma, distress, mental and physical health, culturally competent assessments, and meaningful support and interventions. This crisis requires international support and a global response, as hosting countries have specific competencies and capacities. The authors hope that the...

UNSTRUCTURED This is the authors' responses to peer review reports related to ms#22912.

The UK is currently considering making assisted dying available to patients who are terminally ill. We discuss ethical and practical aspects of this complex issue and outline the potential role of psychiatry. We set out the challenges of implementation of legislation, and potential unintended consequences including the impact on health inequalities...

In this paper, I set out the challenges of care for refugees and suggest approaches to assessment and intervention. I discuss clinical interventions that can address the immediate concern of the clinician in a bio-psycho-social framework, and the value of considering eco-social and structural influences that can hinder recovery and perpetuate inequ...

There are many structural problems facing the UK at present, from a weakened National Health Service to deeply ingrained inequality. These challenges extend through society to clinical practice and have an impact on current mental health research, which was in a perilous state even before the coronavirus pandemic hit. In this editorial, a group of...

Background There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance. Methods We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR...

Background Research shows persistent ethnic inequities in mental health experiences and outcomes, with a higher incidence of illnesses among minoritised ethnic groups. People with psychosis have a higher risk of multiple long-term conditions (MLTC; multimorbidity). However, there is limited research regarding ethnic inequalities in multimorbidity i...

Introduction The Independent Review of the Mental Health Act (MHA) in England and Wales confirmed increasing levels of compulsory detentions, especially for racialised communities. This research aims to: (a) understand the causes of and propose preventive opportunities to reduce the disproportionate use of the MHA, (b) use an adapted form of experi...

Background: Adolescence is a critical period for social and emotional development. We sought to examine the impacts of Covid-19 and related social restrictions and school closures on adolescent mental health, particularly among disadvantaged, marginalised, and vulnerable groups. Methods: We analysed four waves of data - 3 pre-Covid-19 (2016-2019...

Background In the UK, postnatal depression is more common in British South Asian women than White Caucasion women. Cognitive–behavioural therapy (CBT) is recommended as a first-line treatment, but there is little evidence for the adaptation of CBT for postnatal depression to ensure its applicability to different ethnic groups. Aims To evaluate the...

Background Recently, a small literature has emerged suggesting that repetitive transcranial magnetic stimulation (rTMS) may offer benefit for MDD even in BPD patients, perhaps by enhancing cognitive control, and/or disrupting excessive ‘non-reward’ activity in right orbitofrontal regions. This study aimed primarily to assess the therapeutic effects...

Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that impact mental health during the life course. By gathering expertise across the air pollution and mental health fields, we summarise the findings of a rapid scoping discussion, to identify knowledge gaps...

Background Recent evidence on suicide rates among psychiatric patients from minority ethnic backgrounds is scarce. We aimed to examine suicide rates among minority ethnic psychiatric patients and describe their social and clinical characteristics. Methods We did a retrospective observational cohort study on a national case-series of patients in En...

Background Psychosis is associated with many forms of adversity, deprivation and living in urban areas. Aims To investigate whether psychosis is part of a syndemic of multiple adversities. Method Drawing on UK Biobank (UKBB) data (Project ID: 57601), we sought to understand mechanisms by which childhood, recent/contemporary and place-based advers...

[This corrects the article DOI: 10.1016/j.ssmph.2021.100858.].

Resilience is a dynamic, multi-level, multi-systemic process of positive adaptation at the individual, family and community levels. Promoting resilience can be a cost-effective form of preventive and early intervention, offering significant health advantages for young people throughout their lives. Developing resiliency interventions for youth and...

Purpose Knife carrying has caused considerable public concern in the UK. But little is known of the epidemiology and characteristics of men who carry knives. We investigated associations with socioeconomic deprivation, area-level factors, and psychiatric morbidity. Methods Cross-sectional surveys of 5005 British men, 18–34 years, oversampling Blac...

The purpose of this guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the process of migration and the relevant implications for mental health are outline...

Background Psychosis expression in the general population may reflect a behavioral manifestation of the risk for psychotic disorder. It can be conceptualized as an interconnected system of psychotic and affective experiences; a so-called ‘symptom network’. Differences in demographics, as well as exposure to adversities and risk factors, may produce...

This paper examines determinants of ethnic disparities in workplace risks of COVID-19 among health and social care workers (HCWs) in the UK. This was undertaken to inform public health policy in the management of COVID-19 relating to health and social care provision. A cross-sectional survey was administered in July–August 2020 (n = 456) to elicit...

Context: Participatory arts-based methods such as photovoice, drama and music have increasingly been used to engage young people who are exposed to psychosocial risks. These methods have the potential to empower youth and provide them with an accessible and welcoming environment to express and manage difficult feelings and experiences. These effec...

Recent events underscore the morbidity and mortality resulting from structural racism. As cultural specialists , we believe that clinical benefits will accrue from better integrating cultural and societal-structural approaches in psychiatric assessment, care planning, and case management. The Outline for Cultural Formulation (OCF) first appeared in...

Mind, State and Society examines the reforms in psychiatry and mental health services in Britain during 1960–2010, when de-institutionalisation and community care coincided with the increasing dominance of ideologies of social liberalism, identity politics and neoliberal economics. Featuring contributions from leading academics, policymakers, menta...

Background Glasgow, Scotland, has previously shown exceptional levels of violence among young men, shows aggregations of health conditions, with shortened life expectancy. Health conditions can be both causes and consequences of violence, of shared community-level socio-economic risk factors, and can result from large-scale social forces beyond the...

Aims Hypothesis: Personality Disorder (PD) adolescents, compared to non-PD case, have a worse experience at transition. Aims: To describe the outcomes of referrals of adolescents for transition to adult services and compare PD and non-PD populations to identify potential improvements to allow for better transition experience of the PD patients. Ba...

Background Scotland has the shortest life expectancy in Western Europe, driven by high rates of cancer, suicides, alcohol-related causes and drug-related poisonings. These disparities cannot be explained solely by socioeconomic deprivation. Our aim was to investigate whether a syndemic in a socioeconomically deprived area of Glasgow might account f...

The effect of the 2020 pandemic, and of the national measures introduced to control it, is not yet fully understood. The aim of this study was to investigate how different types of primary care data can help quantify the effect of the coronavirus disease (COVID-19) crisis on mental health. A retrospective cohort study investigated changes in weekly...

Background Black, Asian and minority ethnicity groups may experience better health outcomes when living in areas of high own-group ethnic density – the so-called ‘ethnic density’ hypothesis. We tested this hypothesis for the treatment outcome of compulsory admission. Methods Data from the 2010–2011 Mental Health Minimum Dataset ( N = 1 053 617) wa...

Aims and method To evaluate whether a brief training using a Mentalization-Based Treatment (MBT) model improves attitudes of trainee psychiatrists working with patients with personality disorder. Trainee psychiatrists ( n = 49) completed the Attitudes to Personality Disorder Questionnaire before and after a training consisting of two 3 h lectures o...

Background: Psychosis expression in the general population, which may reflect a behavioral manifestation of risk for psychotic disorder, can be conceptualized as an interconnected system of psychotic and affective experiences; a so-called symptom network. Differences in demographics, as well as exposure to adversities and risk factors, may produce...

Background In the UK, around 5% of 11–16-year olds experience conduct problems of clinical importance. However, there are limited data on prevalence of conduct problems by ethnic group, and how putative social risk factors may explain any variations in prevalence. This study has two main aims: (1) to estimate the prevalence and nature of conduct pr...

Ethnic inequalities in the experiences and outcomes of severe mental illness are well established. These include a higher incidence of severe mental illnesses (psychoses), adverse pathways into and through care, including crisis care, police and criminal justice systems involvement, and care under the powers of the Mental Health Act. The situation...

Executive Summary1. In the context of the increasing challenges facing mental health services and in line with existing equalities guidance (including the NHS Tower Hamlets Mental Health Promotion Strategy 2008-2011), the Cultural Consultation Service (CCS) was commissioned by Tower Hamlets NHS with support from the National Mental Health Developme...

Background Photovoice (PV) was conceptualized in the early 1990s to engage community members in capturing/communicating their lived experience narratives through photography. However, no meta-analyses in health research have assessed whether PV achieves its purported effects. Methods We carried forward any relevant references from a previous revie...

Inflammation is a well-known risk factor for chronic physical illnesses. Evidence is building that inflammation is also a risk for mental illnesses making inflammation a common, modifiable mechanism which could potentially explain why mental and physical illnesses are highly comorbid.A rapid synthesis on factors associated to inflammation in the de...

Background Depressive illness and symptoms are known to be common in physical health problems and are present in at least a third of people with chronic kidney disease and end stage renalfailure (CKD/ESKD). Depressive illness and symptoms in CKD/ESKD complicates care, is associated with a shorter life expectancy, and may arise in response to inflam...

Background: Depression is common amongst patients receiving haemodialysis (HD). Assessment and intervention when faced with language and cultural barriers is challenging. To support clinician decisions, we assessed the use of culturally adapted and translated versions of commonly-used depression screening questionnaires with South Asian patients re...

Background: Targeting modifiable risk factors may have a role in the prevention of Alzheimers disease. However, the mechanisms by which these risk factors influence Alzheimers risk remain incompletely understood. Genomic structural equation modelling can reveal patterns of shared genetic architecture that provide insight into the pathophysiology of...

The purpose of this guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the process of migration and the relevant implications for mental health are outline...

In this concluding chapter we review the key concepts and emergent research and practice domains for future investigation. We consider the shift from simple to complicated, complex, and super-complexity sciences as the foundation for future interdisciplinary research and practice, and synthesize the contributions in this chapter towards a future ag...

We set out the remarkable range of contributors to this important and searching set of chapters, which demonstrate interdisciplinary perspectives on how to understand and then prevent terrorism. The authors are scholars and practitioners, and are embedded in their work on a daily basis in systems that tenaciously seek to tackle terrorism on a globa...

Terrorism, Violent Radicalization, and Mental Health brings together distinct disciplinary and ideological narratives on the political, social, economic, and cultural aspects of radicalization and terrorism today. Specifically, adopting methodologies and concepts from cultural psychiatry, and a range of other disciplines, across 18 chapters, we ass...

Participatory arts-based methods such as photovoice, drama and music have been increasingly used to engage young people who are exposed to psychosocial risks. These methods have the potential to empower young people and provide them with a safe and accessible environment to express and manage difficult feelings and experiences. These effects are, h...

UNSTRUCTURED Participatory arts-based methods such as photovoice, drama and music have been increasingly used to engage young people who are exposed to psychosocial risks. These methods have the potential to empower young people and provide them with a safe and accessible environment to express and manage difficult feelings and experiences. These e...

Adverse childhood experiences (ACEs) are a serious public health concern. They effect mental health across the lifespan, lead to social, emotional and cognitive impairment and reduce life expectancy by up to 20 years. Young people experiencing ACEs are highly vulnerable, and therapeutic service provision has limited capacity and in some places poor...

Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiven...

Background There is increasing cross-disciplinary research on the relationship between individuals’ social, cultural and community engagement (SCCE) and mental health. SCCE includes engagement in the arts, culture and heritage, libraries and literature, sports and nature activities, volunteering, and community groups. Research has demonstrated the...

Background The mechanisms by which modifiable risk factors influence Alzheimer’s disease (AD) remain incompletely understood. Previous work using linkage disequilibrium score regression (LDSC) indicates that many of the modifiable risk factors have high genetic correlation with one another. Modelling this shared genetic architecture between risk fa...

Background Racism has been linked with poor health in studies in the United States. Little is known about prospective associations between racial discrimination and health outcomes in the United Kingdom (UK). Methods Data were from 4883 ethnic minority (i.e. non-white) participants in the UK Household Longitudinal Study. Perceived discrimination i...

Purpose: The East London Health and Care Partnership (ELHCP) Data Repository was established to support commissioning decisions in London. This dataset comprises routine clinical data for the general practitioner (GP)-registered populations of two London boroughs, Tower Hamlets and City and Hackney, and provides a rich source of demographic, clini...

Background: Psychiatric comorbidity is known to impact upon use of nonpsychiatric health services. The aim of this systematic review and meta-analysis was to assess the specific impact of severe mental illness (SMI) on the use of inpatient, emergency, and primary care services for nonpsychiatric medical disorders. Methods and findings: PubMed, W...

Cultural diversity poses a challenge to mental Health care systems in many settings. Specialized cultural consultation services have been developed in a number of countries as a way to supplement existing services. The objective of this paper is to compare and contrast cultural consultation services in Montreal, London, and Paris to determine how c...

An amendment to this paper has been published and can be accessed via the original article.