Abstract.
Background:
High rates of compulsory admission of African/Caribbean patients have been reported. Several factors have been associated with this finding. The roles of some factors related to engagement with services have not been empirically evaluated.
Aims:
The aim of this study was to assess the role of engagement factors in compulsory admission of African/Caribbean patients.
Method:
A systematic case-note review was made of the admission process of 100 compulsorily and 100 voluntarily admitted patients; each group containing 50 randomly selected African/Caribbean and White British patients. Information about socio-demographic and engagement factors was collected and the findings compared.
Results:
Compulsorily admitted African/Caribbean patients had more factors indicative of poor engagement with services than patients in the other groups. Prior to admission, they were less likely to keep their appointments, comply with their medication, contact their GPs and were more likely to present late. Furthermore, they had more history of multiple compulsory admissions. The compulsorily admitted patients, irrespective of ethnicity, also engaged poorly with services.
Conclusions:
Poor engagement with primary care and secondary mental health services of African Caribbean patients appears to be contributing to their high rates of compulsory admission. This aspect of ethnic factors and compulsory admission requires further studies.
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References
Adebimpe V (1994) Race, Racism and epidemiological surveys. Hosp Comm Psychiatry 45:27–31
Birchwood M, Cochrane R, Macmillan F, et al. (1992) The Influence of Ethnicity and Family Structure in Relapse of First Episode Schizophrenia. Br J Psychiatry 161:783–790
Cole E, Leavey G, King M, et al. (1995) Pathways to Care for Patients with a first Episode of Psychosis: A Comparison of Ethnic Groups. Br J Psychiatry 167:770–776
Davies S, Thornicroft G, Leese M, et al. (1996) Ethnic differences in risk of compulsory admission among representative cases of psychosis in London. Br Med J 312:533–537
Gardner W, Lidz C, Hoge S, et al. (1999) Patients’ revisions of their beliefs about the need for hospitalisation. Am J Psychiatry 156:1385–1391
Gater R, De Almeida E, Barrirentos G, et al. (1991). The Pathways to Psychiatric Care: A Cross-cultural Study. Psychol Med 21:761–774
Goater N, King M, Cole E, et al. (1999) Ethnicity and outcome of psychosis. Br J Psychiatry 175:34–42
Harrison G, Holton A, Neilson D, et al. (1989) Severe Mental disorder in Afro-Caribbean patients; some social, demographic and service factors. Psychol Med 19:683–696
Harrison J, Poynton A, Marshall J, et al. (1999) Open all hours: extending the role of the psychiatric day hospital. Psychiatr Bull 23:400–404
Huxley P, Reilley S, Gater R, et al. (2000) Matching Resources to Care: acceptability, Validity and Inter-rater Reliability of a new instrument to assess severe mental illness (MARC-1). Soc Psychiatry Psychiatr Epidemiol 35:312–317
Leavey G, King M, Cole E, et al. (1997) First-onset psychotic illness: patients’ and relatives’ satisfaction with services. Br J Psychiatry 170:53–57
Lewis G, Croft-Jeffreys C, David A (1990) Are British Psychiatrists Racist? Br J Psychiatry 157:410–415
McGovern D, Cope R (1987b) The compulsory detention of males of different ethnic groups, with special reference to offender patients. Br J Psychiatry 150:505–512
Moodley P, Thornicroft G (1988) Ethnic group and Compulsory detention. Med Sci Law 28:324–328
Odell S, Surtees P, Wainwright N, et al. (1997) Determinants of general practitioner recognition of psychological problems in a multi-ethnic inner-city health district. Br J Psychiatry 171:537–541
Owens D, Harrison G, Boot D (1991) Ethnic factors in voluntary and compulsory admissions. Psychol Med 21:185–193
Perkins R, Moodley P (1993) Perceptions of problems in psychiatric in-patients: denial, race and service usage. Soc Psychiatry Psychiatr Epidemiol 28:189–193
Rwegellera G (1980) Differential use of psychiatric services by West Indians, West Africans and English in London. Br J Psychiatry 137:428–432
Singh S, Croudace T, Beck A, et al. (1998) Perceived Ethnicity and the risk of compulsory detention. Soc Psychiatry Psychiatr Epidemiol 33:39–44
Smith P, Sheldon A, Martins S, et al. (1996) An index of need for psychiatric services based on in-patient bed utilisation. Br J Psychiatry 169:308–317
Szmukler G, Bird A, Button E (1981) Compulsory admissions in a London borough: Social and clinical features and a follow-up. Psychol Med 11:617–636
Takei N, Persaud R, Woodruff P, et al. (1998) First Episode psychosis in Afro-Caribbean and White people: An 18 year follow-up population study. Br J Psychiatry 172:147–153
Tarrier N, Barrowclough C, Vaughn C, et al. (1988) The Community Management of Schizophrenia: A Controlled Trial of a behavioural intervention to reduce relapse. Br J Psychiatry 153:532–543
Thomas C, Kit S, Osborn M, et al. (1993) Psychiatric Morbidity and Compulsory Admission among UK Born Europeans, Afro-Caribbeans and Asians in Central Manchester. Br J Psychiatry 163:91–99
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Oluwatayo, O., Gater, R. The role of engagement with services in compulsory admission of African/Caribbean patients. Soc Psychiatry Psychiatr Epidemiol 39, 739–743 (2004). https://doi.org/10.1007/s00127-004-0794-9
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DOI: https://doi.org/10.1007/s00127-004-0794-9