Evidence map›Paper›PMID 42580809›Full record

ArticleBMJ mental health2026

Understanding inequities in accessing neurodevelopmental pathways: a multiple methods study investigating healthcare professionals' views on access for minoritised ethnic families.

Sarah Elaine Cooper, Shireen Patel, Camilla Babbage, Kapil Sayal, Madeleine Jane Groom, Jennifer Logan, Vibhore Prasad, Charlotte L Hall

Abstract read
In one paragraph

Article in BMJ mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sarah Elaine CooperNottinghamshire Healthcare NHS Foundation Trust, Institute of Mental Health, Nottingham, UK.ORCID http://orcid.org/0009-0000-5462-7042
Shireen PatelApplied Research Collaboration East Midlands (ARC EM), University of Nottingham, National Institute for Health and Care Research, Nottingham, UK.
Camilla BabbageMindTeach HealthTech Research Centre, School of Medicine, University of Nottingham, National Institute for Health and Care Research, Nottingham, UK.
Kapil SayalSchool of Medicine, Institute of Mental Health, Academic Unit of Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK.ORCID http://orcid.org/0000-0002-2050-4316
Madeleine Jane GroomMindTeach HealthTech Research Centre, School of Medicine, University of Nottingham, National Institute for Health and Care Research, Nottingham, UK.ORCID http://orcid.org/0000-0002-5182-518X
Jennifer LoganStrategy, Transformation and Commercial Development, South West London and Saint George's Mental Health NHS Trust, London, UK.
Vibhore PrasadSchool of Medicine, University of Nottingham, Nottingham, UK.
Charlotte L HallMindTeach HealthTech Research Centre, School of Medicine, University of Nottingham, National Institute for Health and Care Research, Nottingham, UK charlotte.hall@nottingham.ac.uk.ORCID http://orcid.org/0000-0002-5412-6165

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinoritised ethnic families in England experience disproportionate barriers to accessing neurodevelopmental disorder (NDD) assessment and support despite universal healthcare provision. Existing evidence has focused on caregivers' perspectives or non-UK settings but little is known about how healthcare professionals (HCPs) perceive and interpret these inequities. Addressing this gap is essential for improving access, service design and workforce development.

objectiveTo explore HCPs' perceptions of the barriers and facilitators influencing minoritised ethnic families' access to NDD services in England.

methodsA multiple methods design was used, comprising an online national survey (n=264) and two online focus groups with primary, secondary and allied health professionals (n=9). Survey data were summarised descriptively and free text responses analysed using summative content analysis. Focus group transcripts underwent reflexive thematic analysis. Findings were summarised following parallel analysis of each data set. Patient and public involvement and engagement members from minoritised ethnic backgrounds contributed throughout.

findingsHCPs identified four interconnected barriers they perceived to influence access for minoritised ethnic families: (1) language, communication and meaning-making challenges, including differences in how concepts and expressions are understood, inconsistent interpretation and limited mental health literacy; (2) difficulties navigating complex, fragmented NDD pathways, exacerbated by digital literacy demands and unclear referral routes; (3) limited caregiver knowledge and understanding of NDDs, affecting symptom recognition and the ability to advocate effectively and (4) cultural norms, beliefs and stigma, including preferences for non-Western models of care, fear of diagnostic labels and the influence of extended family. Professionals also highlighted the impact of unconscious bias and limited cultural representation within services on referral decision-making and caregiver engagement. HCPs described several effective strategies for mitigating these barriers, such as culturally attuned communication, community-based engagement and flexible assessment approaches.

conclusionsInequitable access to NDD services arises from the interaction of cultural, relational and structural factors across the healthcare pathway. HCPs' insights reveal multiple entry points for improving equity, particularly through communication support, culturally responsive practice and simplified referral processes. CLINICAL IMPLICATIONS: Embedding culturally informed communication, improving caregiver education, strengthening workforce diversity and coproducing service changes with communities may reduce avoidable delays and promote equitable access to neurodevelopmental assessment and support.

Indexed as

Attitude of Health PersonnelEthnicityHealthcare DisparitiesHealth PersonnelHealth Services AccessibilityNeurodevelopmental DisordersAdultChildCommunication BarriersEnglandFemaleFocus GroupsHumansMaleSurveys and QuestionnairesMental HealthMental Health ServicesNeurodevelopmental Disorders

Identifiers

PMID42580809
PMCPMC13475559

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.