Ethnic variation in personality disorder: an evaluation of diagnostic rates of ethnic minority groups compared to the white British majority within Birmingham and Solihull

Purpose This paper aims to explore ethnic variation in the diagnosis of personality disorders across Birmingham and Solihull mental health services. Design/methodology/approach An odds ratio was used to compare diagnostic prevalence rates among ethnic minority groups against the white British majority using service evaluation data. Findings Compared with the white British population, personality disorder was significantly less diagnosed in most ethnic minority groups. A notable exception was the mixed white and black Caribbean group, where prevalence was significantly higher. No significant differences were found in mixed white and Asian and mixed white and black African groups. Practical implications More needs to be done to explore and understand the difference in personality disorder diagnosis rates. It is possible that the differences described in this paper may reflect a true lower prevalence rate, but it is perhaps more likely to reflect difficulties with detection, bias in diagnosis or cultural differences with service use. The findings can help inform more equitable diagnostic practices and highlight the need for culturally competent mental health assessments. Originality/value To the best of the authors’ knowledge, this study is one of few UK-based evaluations exploring ethnic variation in personality disorder diagnosis within a superdiverse urban population. The findings raise important questions about diagnosis, stigma and service accessibility.