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THERACOM: a systematic review of the evidence base for interventions to improve Therapeutic Communications between black and minority ethnic populations and staff in specialist mental health services

Kamaldeep Bhui1*, Rosemarie McCabe2, Scott Weich3, Swaran Singh3, Mark Johnson4 and Ala Szczepura5

Author Affiliations

1 Barts and the London School of Medicine & Dentistry, Wolfson Institute of Preventive Medicine, Room Number: OAB 108, Centre for Psychiatry, Old Anatomy Building, Charterhouse Square, 6BQ, London EC1M, UK

2 Social and Community Psychiatry, Newham Centre for Mental Health, Cherry Tree Way, Glen Road, 8SP, London E13, UK

3 Mental Health & Wellbeing, University of Warwick, Medical School Building, Gibbet Hill Campus, CV4 7AL, Coventry, UK

4 MSRC/CEEHD, De Montfort University, Hawthorn Building 00.20, The Gateway, LE1 9BH, Leicester, UK

5 Health Sciences, Warwick Medical School, Social Studies Building, Main Campus, CV4 7AL, Coventry, UK

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Systematic Reviews 2013, 2:15  doi:10.1186/2046-4053-2-15

Published: 25 February 2013



Black and Minority Ethnic (BME) groups in receipt of specialist mental health care have reported higher rates of detention under the mental health act, less use of psychological therapies, and more dissatisfaction. Although many explanations have been put forward to explain this, a failure of therapeutic communications may explain poorer satisfaction, disengagement from services and ethnic variations in access to less coercive care. Interventions that improve therapeutic communications may offer new approaches to tackle ethnic inequalities in experiences and outcomes.


The THERACOM project is an HTA-funded evidence synthesis review of interventions to improve therapeutic communications between black and minority ethnic patients in contact with specialist mental health services and staff providing those services. This article sets out the protocol methods for a necessarily broad review topic, including appropriate search strategies, dilemmas for classifying different types of therapeutic communications and expectations of the types of interventions to improve them. The review methods will accommodate unexpected types of study and interventions. The findings will be reported in 2013, including a synthesis of the quantitative and grey literature.


A particular methodological challenge is to identify and rate the quality of many different study types, for example, randomised controlled trials, observational quantitative studies, qualitative studies and case studies, which comprise the full range of hierarchies of evidence. We discuss the preliminary methodological challenges and some solutions. (PROSPERO registration number: CRD42011001661).

Interventions; Therapeutic communications; Black and minority ethnic patients; Psychiatric services