In order to implement a successful early intervention service for psychosis, we suggest that cultural, religious and issues surrounding language and communication should be considered.

The delivery of the standard psycho-social interventions used by early intervention services requires effective engagement with the patients.

In June 2003 an audit was conducted amongst 75 patients from different ethnic groups in Luton. Measures of engagement with mental health services included; number of missed outpatient appointments over one year and compliance with medication regimes.

The results of this audit showed that South Asian patients are more likely to miss appointments and refuse to take medication in comparison to their Caucasian or Afro- Caribbean counter-parts. Further analysis revealed that the Bangladeshi subgroup had missed more appointments and had a greater proportion of medication refusal in comparison to the other Asian subgroups.

These results support the pioneering work by Dr Robin Pinto in the 1970s; he observed that Asian patients perceive and utilise mental health services in a different way compared to the Caucasian population.

The observations from our study depict the difficulties in engaging ethnic minority patients into existing services. Hence we argue that future interventions should be adapted and tailored to overcome cultural and language barriers with patients and their families.