No evidence for restrictive care practices in Măori admitted to a New Zealand psychiatric inpatient unit: do specialist cultural teams have a role?
OBJECTIVE
To ascertain the presence, and describe the pattern and extent, of restrictive care practices in the treatment of mental health inpatients in a rural New Zealand unit.


METHODS
Retrospective data was anonymously extracted from patient records at Rotorua Hospital (Rotorua, New Zealand). Data sets were compiled from 300 consecutive patient admissions between January 2000 and December 2001. The demographic and diagnostic characteristics extracted were gender, age, ethnicity (Măori or non-Măori classification only), primary diagnosis, length of hospital stay, seclusion, medication on discharge, dosage of antipsychotic medication if given, referral to psychotherapy, voluntary/involuntary status on admission, and readmission rates.


RESULTS
After controlling for other clinical variables, ethnicity was not associated with specific diagnoses, increased use of seclusion, and involuntary status on admission or higher readmission rates. Măori patients were more likely to receive antipsychotic medication and at higher doses than non-Măori. Măori were less likely to be referred to psychotherapy services and had shorter lengths of stay.


CONCLUSIONS
There was no evidence of widespread restrictive care practices against Măori, although the disparities in antipsychotic prescription and psychotherapy referral suggest some restrictive care practices do exist. The use of specialist cultural teams in general mental health services may prevent restrictive care practices.
Kumar
Shailesh
S
Dept. of Psychiatry, Kingsley Mortimer Unit, North Shore Hospital, Private Bag 93503, Takapuna, Auckland, New Zealand.
Ng
Bradley
B
Simpson
Alexander
A
Fischer
Jesse
J
Robinson
Elizabeth
E
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003431:Cross-Cultural Comparison; D003469:Culture; D005260:Female; D054625:Healthcare Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D009520:New Zealand / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000706:statistics & numerical data*; D024382:Professional Role; D011570:Psychiatry / Q000379:methods; D012424:Rural Population; D013038:Specialization
D014150:Antipsychotic Agents