title: A systematic review of ethnic variations in hospital admission and compulsory detention in first-episode psychosis.
abstract: BACKGROUND
  Marked ethnic variations in incidence, pathways to care and outcomes have been demonstrated in psychosis. Less research has focused specifically on first-episode psychosis (FEP), particularly adverse contacts such as compulsory detention and hospitalization. This is despite international initiatives to promote equity of care and active early intervention.
  
  
  OBJECTIVE
  Systematically review current evidence for ethnic variations in rates of compulsory admission and hospitalization in FEP.
  
  
  METHODS
  Relevant articles published before December 2012 were identified from PubMed, PSYCInfo, and CINAHL together with manual searching of reference lists. Studies providing quantitative data on compulsory detention rates and/or hospitalization, comparing ethnic groups in FEP, were included and quality rated by independent raters.
  
  
  RESULTS
  All included studies (n = 7) provided data on compulsory detention while fewer (n = 3) focused on admission rates. Three studies reported increased detention in Black and minority ethnic groups, while one reported more hospitalization in White patients. Only two studies covered early intervention services (EIS).
  
  
  CONCLUSIONS
  There is a paucity of high quality, well powered studies addressing this important issue, especially in EIS settings. In order to best inform and evaluate fast-developing services, it will be essential to combine large methodologically robust studies with qualitative analysis of patient, carer, and staff experiences.
authors: Department of Mental Health Sciences, University College London , London , UK .
authors: Farhana
authors: F
authors: Mann
authors: Helen L
authors: HL
authors: Fisher
authors: Sonia
authors: S
authors: Johnson
mesh_terms: D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000208:ethnology*
keywords: Compulsory detention; ethnicity; first-episode psychosis; hospitalization; minority ethnic group