<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Camille Duveau</style></author><author><style face="normal" font="default" size="100%">Camille Wets</style></author><author><style face="normal" font="default" size="100%">Katrijn Delaruelle</style></author><author><style face="normal" font="default" size="100%">Stéphanie Demoulin</style></author><author><style face="normal" font="default" size="100%">Dauvrin, Marie</style></author><author><style face="normal" font="default" size="100%">Brice Lepièce</style></author><author><style face="normal" font="default" size="100%">Melissa Ceuterick</style></author><author><style face="normal" font="default" size="100%">Stéphanie De Maesschalck</style></author><author><style face="normal" font="default" size="100%">Piet Bracke</style></author><author><style face="normal" font="default" size="100%">Lorant, Vincent</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Individual, interpersonal, and organisational factors associated with discrimination in medical decisions affecting people with a migration background with mental health problems: the case of general practice.</style></title><secondary-title><style face="normal" font="default" size="100%">Ethn Health</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Ethnicity</style></keyword><keyword><style  face="normal" font="default" size="100%">Family Practice</style></keyword><keyword><style  face="normal" font="default" size="100%">General practice</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Mental health</style></keyword><keyword><style  face="normal" font="default" size="100%">Minority Groups</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2024</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2024 Jan</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">29</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;b&gt;OBJECTIVES: &lt;/b&gt;Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;DESIGN: &lt;/b&gt;An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs ( = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe ( = 7.68,  &amp;lt; 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments ( = 11.55,  &amp;lt; 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress.&lt;/p&gt;

&lt;p&gt;&lt;b&gt;CONCLUSION: &lt;/b&gt;This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients.&lt;/p&gt;
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