Perceptions of electronic health records by minority ethnic groups in mental health: A systematic literature review

Abstract The implementation of Electronic Health Records (EHRs) in mental health contexts has been slow. Reasons for this include concerns from health care professionals regarding the collection of sensitive information and the stigma associated with mental health services. Despite the low uptake of EHRs, the benefits include patients feeling empowered and in control of their own treatment. However, minority ethnic groups often access mental health services through crisis pathways and have been found to disengage with EHRs. The aim of this review was to explore minority ethnic groups’ perceptions of the utility of mental health EHRs and establish perceived barriers and facilitators to access. MEDLINE, CINAHL, EMBASE, Scopus, PsycINFO, PubMed and Web of Science were searched. Included papers mentioned minority ethnic groups from the 37 listed countries on the Organisation for Economic Co-operation and Development, and included service users, clients or patients accessing EHRs in mental healthcare settings. Papers were required to be published between 2009 – 2025. Eight papers met all criteria for inclusion, and three themes emerged: Limited English proficiency as a barrier, Lack of access to technology and Perceived impact of EHRs on access to care. Barriers to access EHRs with limited English proficiency, no access to technology, and stigma was a significant issue for minority ethnic groups due to concerns of who has access to the electronic health data. Benefits of accessing EHRs included easier and efficient access to records. EHRs are critical for modern health systems and further work is required to improve EHRs usage in mental health systems for minority ethnic groups. Competing Interest Statement The authors have declared no competing interest. Clinical Protocols https://www.crd.york.ac.uk/PROSPERO/view/CRD42023494011 Funding Statement The research is a UKRI Brad-ATTAIN funded project. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was not required for the systematic review of available and accessible literature. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes