Abstract
Purpose
To test the hypothesis that ethnic minority status of patients is associated with specific psychotic disorder treatment characteristics.
Methods
Longitudinal data (2001–2005) were extracted from a nationwide psychiatric case register in the Netherlands. The sample consisted of 30,655 episodes of mental health treatment for 23,122 patients with psychotic disorders. Information was available about waiting time and treatment duration, source of referral, occurrence of crisis contacts, admittance to clinical care and compulsory admissions. In addition, information was available about ethnicity (based on country of birth), gender, age and marital status. Results were calculated for ethnic and gender groups separately. In addition, a number of multivariate regression analyses were conducted to correct for differences in age and marital status.
Results
There was substantial variation between ethnic minority and gender groups in relation to the treatment characteristics. Compared with a Dutch ethnic background, ethnic minority background was generally associated with less waiting time, and more police referrals, crisis contacts, admittance to clinical care and compulsory admission, but shorter treatment duration. Characteristics appeared to be least favorable in episodes that involved male patients with Antillean and Surinamese backgrounds, whereas episodes were quite similar for ethnic Dutch and Turkish patients.
Conclusions
Characteristics of mental health treatment for psychosis in the Netherlands are different for ethnic minority patient groups than for patients with an ethnic Dutch background. However, there were substantial differences between ethnic minority groups.
Similar content being viewed by others
References
Rietdijk J, Hogerzeil SJ, van Hemert AM et al (2011) Pathways to psychosis: help-seeking behavior in the prodromal phase. Schizophr Res 132:213–219
Compton MT, Goulding SM, Walker EF (2010) Characteristics of the retrospectively assessed prodromal period in hospitalized patients with first-episode nonaffective psychosis: findings from a socially disadvantaged, low-income, predominantly African American population. J Clin Psychiatry 71:1279–1285
Bota RG, Munro JS, Sagduyu K (2005) Identification of the schizophrenia prodrome in a hospital-based patient population. Mo Med 102:142–146
Addington J, Van MS, Hutchinson J et al (2002) Pathways to care: help seeking behaviour in first episode psychosis. Acta Psychiatr Scand 106:358–364
Anderson KK, Fuhrer R, Schmitz N et al (2013) Determinants of negative pathways to care and their impact on service disengagement in first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol 48:125–136
Anderson KK, Fuhrer R, Malla AK (2010) The pathways to mental health care of first-episode psychosis patients: a systematic review. Psychol Med 40:1585–1597
Platz C, Umbricht DS, Cattapan-Ludewig K et al (2006) Help-seeking pathways in early psychosis. Soc Psychiatry Psychiatr Epidemiol 41:967–974
Pelosi AJ, Birchwood M (2003) Is early intervention for psychosis a waste of valuable resources? Br J Psychiatry 182:196–198
Birchwood M, Connor C, Lester H et al (2013) Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services. Br J Psychiatry 203:58–64
Ghali S, Fisher HL, Joyce J et al (2013) Ethnic variations in pathways into early intervention services for psychosis. Br J Psychiatry 202:277–283
Morgan C, Mallett R, Hutchinson G et al (2005) Pathways to care and ethnicity. 2: source of referral and help-seeking. Report from the AESOP study. Br J Psychiatry 186:290–296
Morgan C, Mallett R, Hutchinson G et al (2005) Pathways to care and ethnicity. 1: sample characteristics and compulsory admission. Report from the AESOP study. Br J Psychiatry 186:281–289
Archie S, Khtar-Danesh N, Norman R et al (2008) Ethnic Diversity and pathways to care for a first episode of psychosis in Ontario. Schizophr Bull 36:688–701
Barrio C, Yamada AM, Hough RL et al (2003) Ethnic disparities in use of public mental health case management services among patients with schizophrenia. Psychiatr Serv 54:1264–1270
Bhugra D, Leff J, Mallett R et al (1997) Incidence and outcome of schizophrenia in whites, African-Caribbeans and Asians in London. Psychol Med 27:791–798
Bhugra D (2006) Severe mental illness across cultures. Acta Psychiatr Scand Suppl 429:17–23
Daumit GL, Crum RM, Guallar E et al (2003) Outpatient prescriptions for atypical antipsychotics for African Americans, Hispanics, and whites in the United States. Arch Gen Psychiatry 60:121–128
Kuno E, Rothbard AB (2002) Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiatry 159:567–572
McGovern D, Hemmings P (1994) A follow-up of second generation Afro-Caribbeans and white British with a first admission diagnosis of schizophrenia: attitudes to mental illness and psychiatric services of patients and relatives. Soc Sci Med 38:117–127
Morgan C, Fearon P, Hutchinson G et al (2006) Duration of untreated psychosis and ethnicity in the AESOP first-onset psychosis study. Psychol Med 36:239–247
Ziguras S, Lambert TJ, McKenzie DP et al (1999) The influence of client’s ethnicity on psychotropic medication management in community mental health services. Aust N Z J Psychiatry 33:882–888
Nerhus M, Berg AO, Haram M, Kvitland LR, Andreassen OA, Melle I (2015) Migrant background and ethnic minority status as predictors for duration of untreated psychosis. Early Interv Psychiatry 9:61–65
Iversen VC, Berg JE, Smavik R, Vaaler AE (2011) Clinical differences between immigrants voluntarily and involuntarily admitted to acute psychiatric units: a 3-year prospective study. J Psychiatr Ment Health Nurs 18:671–676
Fassaert T, Nielen M, Verheij R et al (2010) Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands. Gen Hosp Psychiatry 32:368–376
Koopmans GT, Uiters E, Devillé W, Foets M (2013) The use of outpatient mental health care services of migrants vis-à-vis Dutch natives: equal access? Int J Soc Psych 59:342–350
Fassaert T, Peen J, van Santen A et al (2010) Ethnic differences and similarities in outpatient treatment for depression in the Netherlands. Psychiatr Serv 61:690–697
Selten JP, Veen N, Feller W et al (2001) Incidence of psychotic disorders in immigrant groups to The Netherlands. Br J Psychiatry 178:367–372
Veling W, Selten JP, Veen N et al (2006) Incidence of schizophrenia among ethnic minorities in the Netherlands: a four-year first-contact study. Schizophr Res 86:189–193
Selten JP, Slaets JP, Kahn RS (1997) Schizophrenia in Surinamese and Dutch Antillean immigrants to The Netherlands: evidence of an increased incidence. Psychol Med 27:807–811
Cantor-Graae E, Selten JP (2005) Schizophrenia and migration: a meta-analysis and review. Am J Psychiatry 162:12–24
Selten JP, Laan W, Kupka R et al (2012) Risk of psychiatric treatment for mood disorders and psychotic disorders among migrants and Dutch nationals in Utrecht, The Netherlands. Soc Psychiatry Psychiatr Epidemiol 47:271–278
Boonstra N, Sterk B, Wunderink L et al (2012) Association of treatment delay, migration and urbanicity in psychosis. Eur Psychiatry 27:500–505
de Wit MA, Tuinebreijer WC, van Brussel GH et al (2010) Ethnic differences in risk of acute compulsory admission in Amsterdam, 1996–2005. Soc Psychiatry Psychiatr Epidemiol 47:111–118
van der Post L, Visch I, Mulder C et al (2012) Factors associated with higher risks of emergency compulsory admission for immigrants: a report from the ASAP study. Int J Soc Psychiatry 58:374–380
Mulder CL, Koopmans GT, Selten JP (2006) Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to the Netherlands. Br J Psychiatry 188:386–391
Stronks K, Kulu-Glasgow I, Agyemang C (2009) The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience. Ethn Health 14:1–14
Alders M (2001) Classification of the population with a foreign background in the Netherlands. Statistics Netherlands, Voorburg
Rossler W, Salize HJ, Van OJ et al (2005) Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 15:399–409
Fearon P (2013) Can early intervention services modify pathways into care? Br J Psychiatry 202:249–250
Ferrari M, Flora N, Anderson KK et al (2015) The African, Caribbean and European (ACE) Pathways to Care study: a qualitative exploration of similarities and differences between African-origin, Caribbean-origin and European-origin groups in pathways to care for psychosis. BMJ Open 5:e006562
Stronks K, Ravelli AC, Reijneveld SA (2001) Immigrants in the Netherlands: equal access for equal needs? J Epidemiol Community Health 55:701–707
Uiters E, Deville WL, Foets M et al (2006) Use of health care services by ethnic minorities in The Netherlands: do patterns differ? Eur J Public Health 16:388–393
van der Post L, Mulder CL, Bernardt CM et al (2009) Involuntary admission of emergency psychiatric patients: report from the Amsterdam Study of Acute Psychiatry. Psychiatr Serv 60:1543–1546
van der Post LF, Mulder CL, Peen J et al (2012) Social support and risk of compulsory admission: part IV of the Amsterdam Study of Acute Psychiatry. Psychiatr Serv 63:577–583
Jenner J (2003) Directieve interventies in de acute en de sociale psychiatrie. Van Gorcum, Assen
House of Commons (2013) Online publications and records from Thursday 28 November 2013. http://www.publications.parliament.uk/pa/cm201314/cmhansrd/cm131128/halltext/131128h0001.htm. Accessed 6 Dec 2013
Lay B, Nordt C, Rossler W (2007) Trends in psychiatric hospitalisation of people with schizophrenia: a register-based investigation over the last three decades. Schizophr Res 97:68–78
Trimbos (2012) Trendrapportage GGZ 2012. Deel 1: Organisatie, structuur en financiering. Trimbos, Utrecht
Fassaert T, de Wit MAS, Goedhart G, Verhoeff AP (2010) Etniciteit in onderzoek. Beschouwing vanuit epidemiologisch perspectief. CMG 6(1):22–29
Van Voorhees BW, Fogel J, Houston TK et al (2006) Attitudes and illness factors associated with low perceived need for depression treatment among young adults. Soc Psychiatry Psychiatr Epidemiol 41:746–754
Acknowledgments
The authors acknowledge the Dutch Mental Healthcare Association (GGZ Nederland) for granting access to the ZORGIS database. In addition, the authors thank the reviewers, whose comments helped improve the original manuscript. Finally, the authors would like to thank Daan Uitenbroek for his statistical advice and Anita Wilkinson for checking the manuscript. On behalf of all authors, the corresponding author states that there is no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fassaert, T., Heijnen, H., de Wit, M.A.S. et al. The association between ethnic background and characteristics of first mental health treatment for psychotic disorders in the Netherlands between 2001 and 2005. Soc Psychiatry Psychiatr Epidemiol 51, 1591–1601 (2016). https://doi.org/10.1007/s00127-016-1248-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-016-1248-x