What is it about?
Not much is known about how the diagnosis of personality disorder may differ across different ethnic and cultural backgrounds. We demonstrate in this service evaluation of Birmingham and Solihull adult mental health services that not only is personality disorder largely under-diagnosed in this region, it is disproportionately under-diagnosed in ethnic minority groups. This has important implications about how we identify personality disorder and support access into appropriate services.
Featured Image
Photo by Timothy Blake on Unsplash
Why is it important?
The study shows that people from most minority ethnic groups are less likely to be diagnosed with a personality disorder compared to white British people, despite being in contact with services. This matters because personality disorder is linked to high distress, increased suicide risk, and greater service needs – meaning underdiagnosis could leave some groups without the right support. Differences may reflect cultural bias, difficulties in recognition, or stigma rather than genuine differences in prevalence. By highlighting these disparities, the study underscores the need for fairer, culturally competent assessments and better access to treatment for all groups in a superdiverse population like Birmingham and Solihull.
Perspectives
This study raises important questions about how services are recognising distress, how cultural differences are interpreted, and whether some people are being overlooked or mislabelled. For me, the value of this work is in drawing attention to these disparities and encouraging services to think critically about their assessment practices. It is less about whether a label of “personality disorder” is right or wrong, and more about whether people are able to access appropriate support without bias or unnecessary barriers.
Jack Farr
Birmingham and Solihull Mental Health NHS Foundation Trust
Read the Original
This page is a summary of: Ethnic variation in personality disorder: an evaluation of diagnostic rates of ethnic minority groups compared to the white British majority within Birmingham and Solihull, Mental Health Review Journal, August 2025, Emerald,
DOI: 10.1108/mhrj-11-2024-0080.
You can read the full text:
Contributors
The following have contributed to this page
