title: The role of engagement with services in compulsory admission of African/Caribbean patients.
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.
  
  
  OBJECTIVE
  The aim of this study was to assess the role of engagement factors in compulsory admission of African/Caribbean patients.
  
  
  METHODS
  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.
authors.affiliation: Brandon Mental Health Unit, Leicester General Hospital, Leicester LE5 4PW, UK. olufemi@doctors.org.uk
authors.forename: Olufemi
authors.initials: O
authors.lastname: Oluwatayo
authors.forename: Richard
authors.initials: R
authors.lastname: Gater
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D017691:Caribbean Region / Q000208:ethnology; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000534:rehabilitation*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*