The exclusion of ethnic minorities from healthcare data and GP services
"They don't feel seen. They don't feel heard. What's the point of going to the GP if we're not being seen?"
“The GP was never interested. They never asked, ‘Oh, what's going on here?’ I didn’t even know what mental health was.
“I see it as a blessing. That was finally when they took it seriously. The four days I was in the mental health hospital did not feel like a blessing, but it had to happen to be heard in some way.”
These are the words of Ayan Hussein who is now a qualified therapist and Youth Director at Healtogether, a Somali mental health service based in London.
Throughout her mental health journey, Ms Hussein struggled to understand her somatic symptoms, which were often attributed to anaemia or low vitamin D.
Her mental state worsened after giving birth, when she developed postnatal depression and was admitted to the mother and baby unit.
During her time there, she suffered temporary mutism, a psychological condition that left her unable to talk. After a week, she was unexpectedly able to speak again and asked to see her baby.
Ayan said she was then abruptly discharged with the promise of an annual check-up. The new mother did not hear anything until 12 years later.
Addressing the GP, she said: “You do not know how many times I came to you. You can see it in the records. I kept coming back to you, wanting to be heard within those 12 years.”
Unfortunately, Ayan’s experience is not uncommon, and recent research has uncovered that somatic symptoms disproportionately experienced by ethnic minorities are excluded from the International Classification of Diseases.
Speaking about the people she has helped, Ayan said: “They don't feel seen. They don't feel heard. I have worked with a lot of people who say, ‘What's the point of going to the GP if we're not being seen?’”
"I can't see the light in the clouds. I could just see darkness in my mind. These are signs of depression. I know. I researched it."
One of those people, Amina, 31, is a previous Healtogether service-user, and now works there as a volunteer. In Year 11 she visited the GP, who prescribed her anxiety medication. Her mental health deteriorated, so she went again at 20-years-old.
She said: “I went back to the GP and said, ‘I can't see the light in the clouds. I just see darkness in my mind. These are signs of depression. I know. I researched it.’
“I actually went to the GP saying that I have depression. And the GP said, ‘You don't. You're too young.’”
Instead of depression, her symptoms were recorded as anxiety “because it is a lower-level mental health illness”.
Despite repeatedly returning, Amina was only told to improve her sleeping habits.
Her mental state continued to decline until she experienced psychosis, which prompted doctors to start “taking it more seriously”.
While Amina is now recovering with support from Healtogether, her trust in NHS care remains damaged.
She added: “I am still struggling, but I am coping well now. I just feel like if I do approach them again, they are going to make things worse for me.”
Despite the severity of both women’s conditions, they were not provided sufficient support until their health was critical. Even antidepressants, the most accessible treatment, were not offered to them until much later.
Ayan said: “It is interesting how just last year I was offered antidepressants, 13 years later.”
One in six adults in the UK have a prescription for antidepressants, which many argue reflects a national overprescription crisis.
Yet people of colour are up to four times less likely to be diagnosed with depression or prescribed antidepressants compared to White British patients. On the surface, this may seem like a positive; however, it ultimately reflects inequalities in our healthcare system.
Until 2025, research had rarely explored why this prescription gap exists, even though data on the issue has existed since at least 2016. Even then, the available evidence remains limited and incomplete, as shown in the pie charts above. Despite reviewing the national overprescription crisis, the NHS data did not sufficiently represent diverse groups in the UK.
Additionally, many studies exposing the prescription rate gap have approached the issue indirectly—for example, using antidepressant prescribing rates as a measure of how common depression is.
Rose Rickford, researcher from the PAPER study
The PAPER study
A new study has discovered that people of colour are underrepresented in international healthcare advice, increasing their chances of being misdiagnosed.
The PAPER Study (Prescribing Antidepressants in Primary Care: Ethnic Inequalities in tReatment) published a report in March 2026.
In their research, scholars reviewed The World Health Organization's International Classification of Diseases (ICD-11). They found that despite being recognised as the global standard for diagnosing health conditions, it does not adequately include all somatic symptoms.
For example, symptoms commonly reported by South Asian groups included sleep deprivation, heart-related pain, body aches and incessant negative thinking. Out of these four, only sleep deprivation is included in the ICD-11, which is the only symptom that White people also frequently reported.
Consequently, data shows that many South Asian people tell their GP, ‘my heart kept falling’ or ‘the life would go out of my heart,’ resulting in a heart condition diagnosis.
Additionally, the study also found that GPs are less likely to correctly diagnose British Punjabis with common mental disorders and that, despite consulting with their GP more frequently, Pakistani women in the UK are less likely to receive treatment for depression.
"They think that because you are Black, you lack vitamin D.”
Anab Hoffmann
Founder of Healtogether
Anab Hoffmann, the founder and director of Healtogether, attributed the prescription gap to systemic discrimination.
In particular, she noted young women are struggling with accessing help, making them reluctant to contact healthcare units in the future.
Anab said:“If you are complaining about somatic symptoms but do not know how to articulate it, the GP easily dismisses you.
"They think that because you are Black, you lack vitamin D.”
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