Chenai Mandangu ¹ Anne Millicent Ramos ¹ Mohona Sengupta ¹ Rosslyn Bender ² Reem El-Hayani ¹ Ifrah Hasan ¹ Hannah Okechukwu ¹ Shafeena Anas ³ Dominik Havsteen-Franklin ^3*

• ¹ Imperial College, London, United Kingdom
• ² CNWL NHS Foundation Trust, London, United Kingdom
• ³ Brunel University London, Uxbridge, United Kingdom

Timely and appropriate treatment is fundamental in addressing the burden of mental health issues, which significantly impacts individuals, society, and national healthcare systems. This study investigates implicit bias in the referral practices of mental healthcare professionals to community psychological therapies. By systematically reviewing research from 2002 to 2022, the study identifies recurring themes in referral decision-making and evaluates mechanisms contributing to inequitable access to care. The findings are used to inform evidence-based recommendations for bias mitigation strategies, promoting equitable access. An extensive review of relevant papers published from 2002 to 2022 was conducted, focusing on biases, implicit bias, referral practices, and psychological therapies. The search strategy included fulltext screening based on inclusion criteria to identify studies on professional and organisational implicit bias. Thematic synthesis was used to define relationships and bias development within these categories. The search yielded 2964 papers, with 77 undergoing full-text screening, ultimately including 8 in the review. The thematic review revealed bias development mechanisms across five domains: resource allocation, organizational procedures, clinical roles, decision-making, and referral preferences. This study emphasizes critical themes and proposes measures to mitigate bias and prioritize patients' health and well-being in referral practices. The study provides recommendations to support the provision of equitable psychological therapies in mental health services.