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Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study

Sarah Rees Orcid Logo, Rich Fry Orcid Logo, Jason Davies Orcid Logo, Ann John Orcid Logo, Louise Condon

PLOS ONE, Volume: 18, Issue: 2, Start page: e0281504

Swansea University Authors: Sarah Rees Orcid Logo, Rich Fry Orcid Logo, Jason Davies Orcid Logo, Ann John Orcid Logo, Louise Condon

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DOI (Published version): 10.1371/journal.pone.0281504

Abstract

Introduction: Gypsies and Travellers have poorer physical and mental health than the general population, but little is known about mental health service use by Gypsy and Traveller children and young people. Finding this group in routine electronic health data is challenging, due to limited recording...

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ISSN: 1932-6203
Published: Public Library of Science (PLoS) 2023
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Finding this group in routine electronic health data is challenging, due to limited recording of ethnicity. We assessed the feasibility of using geographical markers combined with linked routine datasets to estimate the mental health service use of children and young people living on Traveller sites. Methods: Welsh Government supplied a list of Traveller site postcodes included in Caravan Counts between 2012 and 2020. Using spatial filtering with data from the Adolescent Mental Health Data Platform (ADP) at Swansea University’s SAIL Databank, we created a cohort of Traveller site residents aged 11–25 years old, 2010–2019. ADP algorithms were used to describe health service use, and to estimate incidence and prevalence of common mental disorders (CMD) and self-harm. Results: Our study found a subgroup of young Gypsies and Travellers (n = 802). We found no significant differences between our cohort and the general population for rates of CMD or self-harm. The rate of non-attendance for psychiatric outpatient follow-up appointments was significantly higher in our cohort. Rates were higher (but not statistically significant) among Gypsies and Travellers for measures suggesting less well-managed care, including emergency department attendance and prescribed CMD medication without follow-up. The small size of the cohort resulted in imprecise estimates with wide confidence intervals, compared with those for the general population. Conclusions: Gypsies and Travellers are under-represented in routine health datasets, even using geographical markers, which find only those resident in authorised traveller sites. Routine data is increasingly relied upon for needs assessment and service planning, which has policy and practice implications for this underserved group. 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spelling v2 62771 2023-02-28 Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study 86073be88970f36d7ffa0a1f0768be2b 0000-0002-1939-0120 Sarah Rees Sarah Rees true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false b7dab4136f5c9c0614cda9bf2d5910b0 0000-0002-1694-5370 Jason Davies Jason Davies true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 6e94805454a9baebe13c15c17f09f3ab Louise Condon Louise Condon true false 2023-02-28 HDAT Introduction: Gypsies and Travellers have poorer physical and mental health than the general population, but little is known about mental health service use by Gypsy and Traveller children and young people. Finding this group in routine electronic health data is challenging, due to limited recording of ethnicity. We assessed the feasibility of using geographical markers combined with linked routine datasets to estimate the mental health service use of children and young people living on Traveller sites. Methods: Welsh Government supplied a list of Traveller site postcodes included in Caravan Counts between 2012 and 2020. Using spatial filtering with data from the Adolescent Mental Health Data Platform (ADP) at Swansea University’s SAIL Databank, we created a cohort of Traveller site residents aged 11–25 years old, 2010–2019. ADP algorithms were used to describe health service use, and to estimate incidence and prevalence of common mental disorders (CMD) and self-harm. Results: Our study found a subgroup of young Gypsies and Travellers (n = 802). We found no significant differences between our cohort and the general population for rates of CMD or self-harm. The rate of non-attendance for psychiatric outpatient follow-up appointments was significantly higher in our cohort. Rates were higher (but not statistically significant) among Gypsies and Travellers for measures suggesting less well-managed care, including emergency department attendance and prescribed CMD medication without follow-up. The small size of the cohort resulted in imprecise estimates with wide confidence intervals, compared with those for the general population. Conclusions: Gypsies and Travellers are under-represented in routine health datasets, even using geographical markers, which find only those resident in authorised traveller sites. Routine data is increasingly relied upon for needs assessment and service planning, which has policy and practice implications for this underserved group. To address health inequalities effort is required to ensure that health datasets accurately capture ethnicity. Journal Article PLOS ONE 18 2 e0281504 Public Library of Science (PLoS) 1932-6203 Health data, mental health services, health inequality, community, Gypsy, Traveller 17 2 2023 2023-02-17 10.1371/journal.pone.0281504 Data Availability Statement: This study utilises data hosted by the Adolescent Mental Health Data Platform (ADP) and SAIL Databank, Swansea University Medical School. These data are not publicly available, but can be accessed for research purposes subject to approval by the ADP/SAIL Databank Information Governance Review Panel (IGRP). Further information about the ADP/SAIL Databank application process is available at https://adolescentmentalhealth.uk/Home and https://saildatabank.com/application-process/. COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) MQ Mental Health research charity, Medical Research Council; MQDS17/36, MQBF/3 ADP, MR/W014386, MC_PC_17211 2023-07-26T16:40:05.8100316 2023-02-28T17:42:26.4776543 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sarah Rees 0000-0002-1939-0120 1 Rich Fry 0000-0002-7968-6679 2 Jason Davies 0000-0002-1694-5370 3 Ann John 0000-0002-5657-6995 4 Louise Condon 5 62771__26773__3df02966e1f24bcfbbb8383292c14f6a.pdf 62771_VoR.pdf 2023-03-07T10:41:36.2339884 Output 1182810 application/pdf Version of Record true © 2023 Rees et al. This is an open access article distributed under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/ 169 SAIL Databank false
title Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
spellingShingle Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
Sarah Rees
Rich Fry
Jason Davies
Ann John
Louise Condon
title_short Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
title_full Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
title_fullStr Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
title_full_unstemmed Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
title_sort Can routine data be used to estimate the mental health service use of children and young people living on Gypsy and Traveller sites in Wales? A feasibility study
author_id_str_mv 86073be88970f36d7ffa0a1f0768be2b
d499b898d447b62c81b2c122598870e0
b7dab4136f5c9c0614cda9bf2d5910b0
ed8a9c37bd7b7235b762d941ef18ee55
6e94805454a9baebe13c15c17f09f3ab
author_id_fullname_str_mv 86073be88970f36d7ffa0a1f0768be2b_***_Sarah Rees
d499b898d447b62c81b2c122598870e0_***_Rich Fry
b7dab4136f5c9c0614cda9bf2d5910b0_***_Jason Davies
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
6e94805454a9baebe13c15c17f09f3ab_***_Louise Condon
author Sarah Rees
Rich Fry
Jason Davies
Ann John
Louise Condon
author2 Sarah Rees
Rich Fry
Jason Davies
Ann John
Louise Condon
format Journal article
container_title PLOS ONE
container_volume 18
container_issue 2
container_start_page e0281504
publishDate 2023
institution Swansea University
issn 1932-6203
doi_str_mv 10.1371/journal.pone.0281504
publisher Public Library of Science (PLoS)
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description Introduction: Gypsies and Travellers have poorer physical and mental health than the general population, but little is known about mental health service use by Gypsy and Traveller children and young people. Finding this group in routine electronic health data is challenging, due to limited recording of ethnicity. We assessed the feasibility of using geographical markers combined with linked routine datasets to estimate the mental health service use of children and young people living on Traveller sites. Methods: Welsh Government supplied a list of Traveller site postcodes included in Caravan Counts between 2012 and 2020. Using spatial filtering with data from the Adolescent Mental Health Data Platform (ADP) at Swansea University’s SAIL Databank, we created a cohort of Traveller site residents aged 11–25 years old, 2010–2019. ADP algorithms were used to describe health service use, and to estimate incidence and prevalence of common mental disorders (CMD) and self-harm. Results: Our study found a subgroup of young Gypsies and Travellers (n = 802). We found no significant differences between our cohort and the general population for rates of CMD or self-harm. The rate of non-attendance for psychiatric outpatient follow-up appointments was significantly higher in our cohort. Rates were higher (but not statistically significant) among Gypsies and Travellers for measures suggesting less well-managed care, including emergency department attendance and prescribed CMD medication without follow-up. The small size of the cohort resulted in imprecise estimates with wide confidence intervals, compared with those for the general population. Conclusions: Gypsies and Travellers are under-represented in routine health datasets, even using geographical markers, which find only those resident in authorised traveller sites. Routine data is increasingly relied upon for needs assessment and service planning, which has policy and practice implications for this underserved group. To address health inequalities effort is required to ensure that health datasets accurately capture ethnicity.
published_date 2023-02-17T16:39:20Z
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