No evidence for restrictive care practices in Māori admitted to a New Zealand psychiatric inpatient unit: do specialist cultural teams have a role?
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- Kumar, S., Ng, B., Simpson, A. et al. Soc Psychiat Epidemiol (2008) 43: 387. doi:10.1007/s00127-008-0320-6
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To ascertain the presence, and describe the pattern and extent, of restrictive care practices in the treatment of mental health inpatients in a rural New Zealand unit.
Retrospective data was anonymously extracted from patient records at Rotorua Hospital (Rotorua, New Zealand). Data sets were compiled from 300 consecutive patient admissions between January 2000 and December 2001. The demographic and diagnostic characteristics extracted were gender, age, ethnicity (Māori or non-Māori classification only), primary diagnosis, length of hospital stay, seclusion, medication on discharge, dosage of antipsychotic medication if given, referral to psychotherapy, voluntary/involuntary status on admission, and readmission rates.
After controlling for other clinical variables, ethnicity was not associated with specific diagnoses, increased use of seclusion, and involuntary status on admission or higher readmission rates. Māori patients were more likely to receive antipsychotic medication and at higher doses than non-Māori. Māori were less likely to be referred to psychotherapy services and had shorter lengths of stay.
There was no evidence of widespread restrictive care practices against Māori, although the disparities in antipsychotic prescription and psychotherapy referral suggest some restrictive care practices do exist. The use of specialist cultural teams in general mental health services may prevent restrictive care practices.