title: Factors associated with higher risks of emergency compulsory admission for immigrants: a report from the ASAP study.
abstract: OBJECTIVE
  Specific ethnic groups appear to be disproportionally represented in emergency compulsory admissions. This may be due to a parallel higher risk of psychopathology, but different pathways to care in patients from ethnic minorities may also be an explanatory factor. In this article we concentrate on the influence of ethnic background, pathways to psychiatric emergency services and the amount of past psychiatric treatment as predictors of emergency compulsory admission.
  
  
  METHODS
  All the patients coming into contact consecutively with the Psychiatric Emergency Service Amsterdam (PESA) from September 2004 to September 2006 were included in the study. We collected socio-demographic and clinical characteristics, and data about prior use of mental health services and referral to the emergency service.
  
  
  RESULTS
  The risk of compulsory admission for immigrants from Surinam and the Dutch Antilles (OR 2.6), sub-Saharan Africa (OR 3.1), Morocco and other non-Western countries (each OR 1.7) was significantly higher than for native Dutch people. After controlling for socio-demographic characteristics, diagnosis, referral pattern and psychiatric treatment history, this correlation was no longer found.
  
  
  CONCLUSIONS
  We found no evidence to substantiate the hypothesis that ethnic background plays an independent role in emergency compulsory admission. Police referral rather than referral by a GP, and being diagnosed with a psychosis, seemed to be explanatory factors for the high risk of compulsory admission for non-Western immigrants. Infrequent contact with secondary mental healthcare during the previous five years was not found to be consistently associated with a higher risk.
authors.affiliation: ARKIN Mental Health Care, Amsterdam, Netherlands. lvdp@xs4all.nl
authors.forename: Louk
authors.initials: L
authors.lastname: van der Post
authors.forename: Irene
authors.initials: I
authors.lastname: Visch
authors.forename: Cornelis
authors.initials: C
authors.lastname: Mulder
authors.forename: Robert
authors.initials: R
authors.lastname: Schoevers
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
authors.forename: Aartjan
authors.initials: A
authors.lastname: Beekman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003134:Commitment of Persons with Psychiatric Disorders; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment