Ethnic differences among patients in high-security psychiatric hospitals in England.
BACKGROUND
Black (Black Caribbean and Black African) patients are over-represented in admissions to general adult and medium-security psychiatric services in England.


OBJECTIVE
To describe the sociodemographic, clinical and offence characteristics of patients in high-security psychiatric hospitals (HSPHs) in England, and to compare admission rates and unmet needs by ethnic group.


METHODS
A total of 1255 in-patients were interviewed, and their legal status, socio-demographic characteristics and individual treatment needs were assessed.


RESULTS
Black patients in HSPHs are over-represented by 8.2 times (range 3.2-24.4,95% CI 7.1-9.3), are more often male (P=0.037), and are more often diagnosed with a mental illness and less often diagnosed with a personality disorder or learning disability (P<0.001) than White patients. Unmet needs were significantly less common among White than among Black patients (mean values of 2.22 v. 2.62, difference=0.40,95% CI 0.06-0.73).


CONCLUSIONS
Compared with the proportion of Black patients in the general population in their region of origin, a much higher proportion of Black patients were admitted to HSPHs, and fewer of their needs were met.
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
Morven
M
Leese
Graham
G
Thornicroft
Jenny
J
Shaw
Stuart
S
Thomas
Rajesh
R
Mohan
Mari Anne
MA
Harty
Mairead
M
Dolan
D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000208:ethnology*; D012926:Social Control, Formal; D014852:Wales / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*