title: Ethnic differences in mental health service use among patients with psychotic disorders.
abstract: BACKGROUND
  There are concerns that ethnic minority patients are over-represented in inpatient mental health settings, but under-utilise community services. This study aims to compare the use of community mental health services between African-Caribbean and White patients with psychosis, before and after the introduction of new community services, and to investigate their impact on inpatient treatment.
  
  
  METHODS
  The sample was drawn from epidemiologically representative patients with psychotic disorders living in two catchment areas in South London, one of which was developing intensive community treatments. Service utilisation was measured at baseline and at 2-year follow-up using the Client Service Receipt Interview (CSRI). The mean number of contacts with specific services was compared between the two groups over time.
  
  
  RESULTS
  A total of 92 White and 48 African-Caribbean patients were compared. The latter were more likely to be younger (P = 0.004), have shorter illness duration (P < 0.001), and had more detentions under the Mental Health Act (P = 0.003). No significant differences were seen in use of community services over time. However, intensive treatment led to a significant reduction in hospital days for African Caribbean patients compared to White patients in the intensive sector and all patients in the standard sector.
  
  
  CONCLUSIONS
  Intensive community treatments reduced inpatient days in African Caribbean patients. Further effort is needed to improve the cultural sensitivity of community mental health services.
authors.affiliation: Section of Social and Cultural Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. r.mohan@iop.kcl.ac.uk
authors.forename: Rajesh
authors.initials: R
authors.lastname: Mohan
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: George
authors.initials: G
authors.lastname: Szmukler
authors.forename: Nadia
authors.initials: N
authors.lastname: Micali
authors.forename: Sarah
authors.initials: S
authors.lastname: Afuwape
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology; D017691:Caribbean Region / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011618:Psychotic Disorders / Q000628:therapy*