Healthcare professionals’ perspectives on minoritised ethnic young people’s access to eating disorder services in the West Midlands, United Kingdom: a qualitative study
Williams-Ridgway, Aliyah-Mae McNeil, Sheryllin Leung, Newman Hamilton, Donna Bilkhu, Sukbinder Winston, Anthony P Tuomainen, Helena
Williams-Ridgway, Aliyah-Mae
McNeil, Sheryllin
Leung, Newman
Hamilton, Donna
Bilkhu, Sukbinder
Winston, Anthony P
Tuomainen, Helena
Affiliation
University of Warwick; Birmingham and Solihull Mental Health NHS Foundation Trust; University of Birmingham; Leicestershire Partnership NHS Trust; Coventry and Warwickshire Partnership NHS Trust;
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Publication date
2026-02
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Abstract
Background: Minoritised ethnic individuals have comparable eating disorder rates to White populations in the United Kingdom (UK) yet face inequalities in treatment access and experiences. Understanding healthcare professional perspectives is essential for addressing these disparities. This study explores health care professional views on the access of minoritised ethnic young people to specialist eating disorder services through Levesque's bidirectional access framework, which considers both supply and demand factors.
Methods: Semi-structured qualitative interviews were conducted with 12 health care professionals from diverse personal and professional backgrounds, recruited from four National Health Service (NHS) community specialist eating disorder services in the West Midlands - the UK's second most ethnically diverse region. Participants completed sociodemographic questionnaires and online interviews via Microsoft Teams. Transcripts were analysed using reflexive thematic analysis.
Results: Health care professionals observed that young people of minoritised ethnic backgrounds accessed specialist eating disorder services less frequently than White British peers. Analysis revealed six interconnected themes spanning service-level and service-user-level factors. At the service level, systemic barriers included gatekeeping mechanisms (particularly GP referral requirements), service invisibility within minoritised ethnic communities, and inaccessible locations. Cultural and linguistic barriers were prominent, with communication challenges extending beyond language proficiency to fundamental differences in expressing distress. Health care professionals identified critical gaps in developing culturally sensitive services, citing limited resources, lack of workforce diversity, top-down organizational constraints, and insufficient cultural humility training. At the service-user level, education and awareness emerged as key barriers, with lower mental health literacy and limited eating disorder knowledge within minoritised ethnic communities as hindering recognition and help-seeking. Shame and stigma compounded these challenges, driven by eating disorder stereotypes and cultural beliefs about mental health that discouraged disclosure and treatment-seeking. Health care professionals noted that these barriers disproportionately affected minoritised ethnic individuals compared to their White British peers.
Conclusions: Findings highlight multilevel barriers to accessing eating disorder services requiring comprehensive system changes including removing gatekeeping barriers, enhancing workforce diversity and cultural competency, developing targeted educational initiatives, and challenging eating disorder stereotypes. Culturally responsive services integrating these interventions are essential to improve access and outcomes for minoritised ethnic young people.
Citation
Williams-Ridgway AM, McNeil S, Leung N, Hamilton D, Bilkhu S, Winston AP, Tuomainen H. Healthcare professionals' perspectives on minoritised ethnic young people's access to eating disorder services in the West Midlands, United Kingdom: a qualitative study. J Eat Disord. 2026 Feb 18. doi: 10.1186/s40337-026-01546-5. Epub ahead of print. PMID: 41709297.
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Article