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Ethnic differences in admissions to secure forensic psychiatry services
1Academic Section of Forensic Psychiatry, St Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
African-Caribbean individuals show higher rates of compulsory psychiatric admissions for mental disorders compared to White individuals. This suggests community services may be less effective for this population.
Area of Science:
- Forensic Psychiatry
- Public Health
- Ethnic Disparities in Mental Healthcare
Background:
- Persons of African-Caribbean origin experience higher rates of imprisonment.
- Evidence indicates increased psychiatric hospital detentions for this group following offending behavior.
Purpose of the Study:
- To estimate population-based prevalence rates of treated mental disorder.
- To compare rates across different ethnic groups.
- Focus on compulsory admissions to secure forensic psychiatry services.
Main Methods:
- Survey of 3155 first admissions from 1988-1994.
- Data from half of England and Wales.
- 1991 census data used as denominator, adjusted for under-enumeration.
Main Results:
- Black males had 5.6 times higher compulsory admissions than White males.
- Asian males had half the admissions of White males.
- Black females had 2.9 times higher admissions, Asian females one-third.
- Non-White admissions increased over the study period.
- Differences in offending patterns and diagnoses observed between ethnic groups.
Conclusions:
- Observed variations in compulsory hospitalization are not solely due to racial bias.
- Community-based services may be less effective in managing escalating criminal and dangerous behavior associated with mental illness in African-Caribbeans.
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