Ethnic differences in admissions to secure forensic psychiatry services.
BACKGROUND
Persons of African-Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour.


OBJECTIVE
To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services.


METHODS
A survey was recorded of 3155 first admissions, from 1988 to 1994, from half of England and Wales, with 1991 census data as the denominator adjusted for under-enumeration.


RESULTS
Compulsory admissions for Black males were 5.6 (CI 5.1-6.3) times as high as, and for Asian males were half, those for White males; for Black females, 2.9 (CI 2.4-4.6) times as high and for Asian females one-third of those for White females. Admissions of non-Whites rose over the study period. Patterns of offending and diagnoses differed between ethnic groups.


CONCLUSIONS
Variations in compulsory hospitalisation cannot be entirely attributed to racial bias. Community-based services may be less effective in preventing escalating criminal and dangerous behaviour associated with mental illness in African-Caribbeans.
Coid
J
J
Academic Section of Forensic Psychiatry, St Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
Kahtan
N
N
Gault
S
S
Jarman
B
B
D000293:Adolescent; D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005555:Forensic Psychiatry / Q000458:organization & administration; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000517:prevention & control; D012307:Risk Factors; D012926:Social Control, Formal; D012935:Social Justice; D012959:Socioeconomic Factors; D014852:Wales / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology