Li, Lyndsey; (2025) Understanding and improving the mental health outcomes of psychological interventions for the ethnic Chinese population. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis aims to understand the effectiveness of psychological interventions in treating common mental disorders of ethnic Chinese population, and to inform potential improvements in mental healthcare provision for this population. A number of studies were conducted to explore what might be specific about the response to psychological interventions of ethnic Chinese with common mental disorders in different societal contexts. The introduction discusses the history of and contemporary mental health developments in China, followed by a literature review of the cultural specificity of mental health disorders and psychological interventions. A systematic review and meta-analysis builds upon existing literature on cultural adaptations by exploring the effectiveness of culturally modified and culturally specific psychological interventions. This provides empirical evidence on the effectiveness of both cultural adaptation approaches. A second systematic review of trial methods and the reporting of clinical trials of psychological interventions in treating ethnic Chinese highlights a number of serious concerns about this body of literature published in China. Possible underlying reasons for these are discussed with suggestions for system level changes to improve trial conduct and reporting. The following two chapters explore the clinical profiles and outcomes of the ethnic Chinese population in a different societal context; that is those living in the UK as minoritised ethnic group. This begins with an analysis of patient demographic and clinical outcome data from routine mental health services to explore patient or service factors that may be associated with treatment outcomes. Latent profile analysis was performed to identify distinct subgroups within Chinese patients accessing routine mental health services and their association with treatment outcomes. The overall findings support the important role of culture in the delivery and evaluation of psychological interventions in treating ethnic Chinese. Implications for practices and future research are discussed to improve treatment outcomes for this population.

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