Mental health care for Asian, black and white patients with non-affective psychoses: pathways to the psychiatric hospital, in-patient and after-care

Abstract

Background: This UK-based study compares the pathways to the psychiatric hospital and the provision of in-patient and after-care for Asian, black and white patients with non-affective psychoses. Methods: Two overlapping samples of 120 patients, 40 from each ethnic group, were drawn; one on admission and the other at discharge. In addition to socio-demographic data, details were obtained on the pathways to care and the in-patient episode. An assessment of needs and service provision was undertaken 3 months post-discharge. Patient satisfaction was ascertained at each stage. Results: Asian and especially black patients experienced more complex pathways and had higher levels of both involvement with the police and compulsory detention than their white counterparts. They were less likely to perceive themselves as having a psychiatric problem or as needing to go into hospital and expressed less satisfaction with the admission process. Black patients, as compared to Asian but especially white patients, were more often detained in hospital against their will, confined to the ward and treated within a secure environment. However, there were few differences in satisfaction with hospital care. Likewise, perceptions of unmet need, provision of after-care and satisfaction with services were similar across the ethnic groups. Conclusions: The implications of these findings are discussed. The potential of early intervention programmes and home treatment services to address the ethnic differentials identified in this study merit consideration.