Cultural differences in pathways to care, service use and treated outcomes

In the rapidly evolving relationships between mental healthcare providers and their clients, the focus is increasingly on cultural factors influencing pathways to care, service use and treated outcomes. Higher levels of service use in groups with different cultural characteristics may be associated with poor prognosis, a high level of exposure to group-specific precipitant factors or a selective, more interventionist treatment approach by the majority culture mental health professionals. On the other hand, low levels of service use in some groups may be associated with under-recognition of mental disorder, protective factors, differences in constructs of illness aetiology or better outcome. The longitudinal research necessary to investigate these issues further is long overdue.