Ethnic variations in compulsory detention and hospital admission for psychosis across four UK Early Intervention Services

BMC Psychiatry

Research Article

Mark F Hinton¹  Sonia Johnson¹  Farhana Mann²  Barnaby Major³  Helen L Fisher⁴  Jo Lawrence⁵  Andrew Tapfumaneyi⁵  John Joyce⁵ 

[1] Division of Psychiatry, UCL, Charles Bell House, 67-73 Riding House Street, W1W 7EJ, London, UK;Camden and Islington NHS Foundation Trust, London, UK;Division of Psychiatry, UCL, Charles Bell House, 67-73 Riding House Street, W1W 7EJ, London, UK;the MiData Consortium, UK;East London NHS Foundation Trust, London, UK;MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK;South London and Maudsley NHS Foundation Trust, London, UK;

关键词: Psychosis;    Early intervention;    Ethnic;    Compulsory detention;    Admission;   

DOI  :  10.1186/s12888-014-0256-1

 received in 2014-06-18, accepted in 2014-08-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundSubstantial ethnic variations have been found in incidence, pathways to care and outcomes in psychosis. It is unknown whether these remain as marked in the presence of specialist Early Intervention Services (EIS) for psychosis. We present the first UK study exploring ethnic differences in compulsory detention and hospitalization rates for EIS patients. We investigated whether the excess rates of compulsory admission for people from Black groups have persisted following nationwide introduction of EIS. We also explored variations in compulsory admission for other ethnic groups, and differences by gender and diagnosis.MethodsFour inner-city London EIS teams gathered data from first-presentation psychosis patients between 2004-2009 using the MiData audit tool. Clinical, sociodemographic and pathways to care data were recorded regarding adult patients from eight different ethnic groups at entry to EIS and one year later.ResultsBlack African EIS service users had odds of being detained and of being hospitalised three times greater than White British patients, even after adjustment for confounders. This was most marked in Black African women (seven to eight times greater odds than White British women). A post-hoc analysis showed that pathways to care and help-seeking behaviour partially explained these differences.ConclusionThese findings suggest EIS input in its current form has little impact on higher admission and detention rates in certain Black and minority groups. There is a need to tackle these differences and engage patients earlier, focusing on the needs of men and women from the most persistently affected groups.

【 授权许可】

Unknown   
© Mann et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.