Health Care Inequalities within Dementia Care: A Thematic Analysis of Royal College of Psychiatrists UK Survey
Hari Subramaniam, Shahbaz Abdullah, Damodar Chari, Elizabeta Mukaetova-Ladinska, Sujoy Mukherjee, Mohan BhatAbstract
Background and Aims
Ethnic Minority (EM) groups face health care inequalities within memory pathways related to language barriers, issues of access, culturally misaligned diagnostic tools and dementia misconceptions leading to delayed diagnosis, under-diagnosis and poorer health outcomes. We aimed to explore clinicians' perspectives on these inequalities within UK memory services.
Methods
Old Age Faculty of the Royal College of Psychiatrists conducted a UK-wide survey of clinicians working in dementia services during 2025. Free-text responses were thematically analysed using Braun and Clarke's six-stage thematic analysis within NVivo (v13).
Results
Five major themes emerged: (1) underrepresentation and late presentation; (2) language and communication barriers; (3) family and cultural context; (4) service-level challenges and inequities; and (5) clinical complexity and comorbidities. Respondents described delayed access to diagnosis, inconsistent interpreter provision, culturally inappropriate cognitive assessment tools, limited culturally tailored post diagnostic support and significant variations in service provision. Many considered these disparities to arise from structural rather than individual factors.
Conclusion
Clinicians perceive inequalities throughout dementia care pathways for EM populations. Improved interpreter provision, adapted assessment tools, strengthening community engagement and embedding cultural competence within service design may improve equity in dementia care, essential to provide equitable assessments and supports in multi-cultural, multiethnic populations.