Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1996 Mar 2;312(7030):533–537. doi: 10.1136/bmj.312.7030.533

Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London.

S Davies 1, G Thornicroft 1, M Leese 1, A Higgingbotham 1, M Phelan 1
PMCID: PMC2350333  PMID: 8595280

Abstract

OBJECTIVE--To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING--Two defined geographical areas in south London. DESIGN--Annual period prevalent cases of psychosis were identified in 1993 in the study areas from hospital and community data. Standardised criteria were applied to case notes to establish diagnosis and detention under the act. SUBJECTS--535 patients were identified, of whom 439 fulfilled ICD-10 criteria for psychosis. MAIN OUTCOME MEASURES--Risk of ever having been detained under the Mental Health Act 1983, risk of detention under specific sections of the act during the study year, and risk of contact with forensic services for the different ethnic groups. RESULTS--439 patients with a psychotic illness were identified. Nearly half of the white patients had been detained under the act compared with 70% and 69% of black Caribbean and black African patients, respectively. Black Caribbean and black African patients were more likely than white patients to have been involuntarily detained (adjusted odds ratio 3.67; 95% confidence interval 2.07 to 6.50 and 2.88; 1.04 to 7.95, respectively). Rates of use of sections 2, 3 and 136 in the study year were higher for black than for white patients, and black patients were more likely than white patients to have been admitted to a psychiatric intensive care facility or prison. CONCLUSION--Independent of psychiatric diagnosis and sociodemographic differences, black African and black Caribbean patients with psychosis in south London were more likely than white patients to have ever been detained under the Mental Health Act 1983.

Full text

PDF
533

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bebbington P. E., Feeney S. T., Flannigan C. B., Glover G. R., Lewis S. W., Wing J. K. Inner London collaborative audit of admissions in two health districts. II: Ethnicity and the use of the Mental Health Act. Br J Psychiatry. 1994 Dec;165(6):743-9, 759. doi: 10.1192/bjp.165.6.743. [DOI] [PubMed] [Google Scholar]
  2. Bebbington P., Hurry J., Tennant C., Sturt E., Wing J. K. Epidemiology of mental disorders in Camberwell. Psychol Med. 1981 Aug;11(3):561–579. doi: 10.1017/s0033291700052879. [DOI] [PubMed] [Google Scholar]
  3. Castle D., Wessely S., Der G., Murray R. M. The incidence of operationally defined schizophrenia in Camberwell, 1965-84. Br J Psychiatry. 1991 Dec;159:790–794. doi: 10.1192/bjp.159.6.790. [DOI] [PubMed] [Google Scholar]
  4. Harrison G., Holton A., Neilson D., Owens D., Boot D., Cooper J. Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychol Med. 1989 Aug;19(3):683–696. doi: 10.1017/s0033291700024284. [DOI] [PubMed] [Google Scholar]
  5. Harrison G., Ineichen B., Smith J., Morgan H. G. Psychiatric hospital admissions in Bristol. II. Social and clinical aspects of compulsory admission. Br J Psychiatry. 1984 Dec;145:605–611. doi: 10.1192/bjp.145.6.605. [DOI] [PubMed] [Google Scholar]
  6. Harrison G., Owens D., Holton A., Neilson D., Boot D. A prospective study of severe mental disorder in Afro-Caribbean patients. Psychol Med. 1988 Aug;18(3):643–657. doi: 10.1017/s0033291700008321. [DOI] [PubMed] [Google Scholar]
  7. Ineichen B., Harrison G., Morgan H. G. Psychiatric hospital admissions in Bristol. I. Geographical and ethnic factors. Br J Psychiatry. 1984 Dec;145:600–604. doi: 10.1192/bjp.145.6.600. [DOI] [PubMed] [Google Scholar]
  8. Ineichen B. Schizophrenia in British Afro-Caribbeans: two debates confused? Int J Soc Psychiatry. 1991 Winter;37(4):227–232. doi: 10.1177/002076409103700401. [DOI] [PubMed] [Google Scholar]
  9. Ineichen B. The mental health of Asians in Britain. BMJ. 1990 Jun 30;300(6741):1669–1670. doi: 10.1136/bmj.300.6741.1669. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. King M., Coker E., Leavey G., Hoare A., Johnson-Sabine E. Incidence of psychotic illness in London: comparison of ethnic groups. BMJ. 1994 Oct 29;309(6962):1115–1119. doi: 10.1136/bmj.309.6962.1115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Littlewood R., Lipsedge M. Acute psychotic reactions in Caribbean-born patients. Psychol Med. 1981 May;11(2):303–318. doi: 10.1017/s0033291700052120. [DOI] [PubMed] [Google Scholar]
  12. London M. Mental illness among immigrant minorities in the United Kingdom. Br J Psychiatry. 1986 Sep;149:265–273. doi: 10.1192/bjp.149.3.265. [DOI] [PubMed] [Google Scholar]
  13. McGovern D., Cope R. Second generation Afro-Caribbeans and young whites with a first admission diagnosis of schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1991 Mar;26(2):95–99. doi: 10.1007/BF00791535. [DOI] [PubMed] [Google Scholar]
  14. McGovern D., Cope R. The compulsory detention of males of different ethnic groups, with special reference to offender patients. Br J Psychiatry. 1987 Apr;150:505–512. doi: 10.1192/bjp.150.4.505. [DOI] [PubMed] [Google Scholar]
  15. McGuffin P., Farmer A., Harvey I. A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Arch Gen Psychiatry. 1991 Aug;48(8):764–770. doi: 10.1001/archpsyc.1991.01810320088015. [DOI] [PubMed] [Google Scholar]
  16. McKenzie K. J., Crowcroft N. S. Race, ethnicity, culture, and science. BMJ. 1994 Jul 30;309(6950):286–287. doi: 10.1136/bmj.309.6950.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Moodley P., Thornicroft G. Ethnic group and compulsory detention. Med Sci Law. 1988 Oct;28(4):324–328. doi: 10.1177/002580248802800412. [DOI] [PubMed] [Google Scholar]
  18. Owens D., Harrison G., Boot D. Ethnic factors in voluntary and compulsory admissions. Psychol Med. 1991 Feb;21(1):185–196. doi: 10.1017/s003329170001477x. [DOI] [PubMed] [Google Scholar]
  19. Senior P. A., Bhopal R. Ethnicity as a variable in epidemiological research. BMJ. 1994 Jul 30;309(6950):327–330. doi: 10.1136/bmj.309.6950.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Szmukler G. I., Bird A. S., Button E. J. Compulsory admissions in a London borough: I. Social and clinical features and a follow-up. Psychol Med. 1981 Aug;11(3):617–636. doi: 10.1017/s0033291700052909. [DOI] [PubMed] [Google Scholar]
  21. Thomas C. S., Stone K., Osborn M., Thomas P. F., Fisher M. Psychiatric morbidity and compulsory admission among UK-born Europeans, Afro-Caribbeans and Asians in central Manchester. Br J Psychiatry. 1993 Jul;163:91–99. doi: 10.1192/bjp.163.1.91. [DOI] [PubMed] [Google Scholar]
  22. Turner T. H., Ness M. N., Imison C. T. 'Mentally disordered persons found in public places'. Diagnostic and social aspects of police referrals (Section 136). Psychol Med. 1992 Aug;22(3):765–774. doi: 10.1017/s0033291700038204. [DOI] [PubMed] [Google Scholar]
  23. Wessely S. C., Castle D., Douglas A. J., Taylor P. J. The criminal careers of incident cases of schizophrenia. Psychol Med. 1994 May;24(2):483–502. doi: 10.1017/s0033291700027458. [DOI] [PubMed] [Google Scholar]
  24. Wessely S., Castle D., Der G., Murray R. Schizophrenia and Afro-Caribbeans. A case-control study. Br J Psychiatry. 1991 Dec;159:795–801. doi: 10.1192/bjp.159.6.795. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES