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Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB. An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs (n = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables. Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe (F = 7.68, p < 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments (F = 11.55, p < 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress. This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients. [ABSTRACT FROM AUTHOR]

Many university students engage in risky alcohol consumption behaviour during their stay at university. So far, however, most studies have relied on cross-sectional surveys and paid little attention to the role of social ties. University students, however, are socially connected, so it is likely that their alcohol consumption behaviour is also connected. We hypothesized that university students' social positions within their networks are related to their drinking behaviour. We carried out a social network analysis within a whole network approach with undergraduates in two faculties (n = 487), those of Engineering and Psychology, in a Belgian university. All students filled out a questionnaire recording their drinking behaviour and their social ties (friendship, working with, partying with and room-mate). For each individual, indicators of centrality, social capital, and cross-gender relationships were computed. We found that being socially close to binge drinkers was associated with a higher frequency of binge drinking. The risk of binge drinking increased with centrality but decreased with social capital. Having cross-gender relationships decreased the risk of binge drinking. We found indications that the effect of centrality and gender on binge drinking depends on the composition of the network. We conclude that social position has important effects on risky drinking behaviour and that the composition of the network may affect these factors. Those developing health promotion strategies could investigate the benefits of targeting central individuals in order to prevent binge drinking among university students. [ABSTRACT FROM AUTHOR]