title: Criminal justice pathways to psychiatric care for psychosis.
abstract: BACKGROUND
  Some patients are at higher risk of contact with criminal justice agencies when experiencing a first episode of psychosis.
  
  
  OBJECTIVE
  To investigate whether violence explains criminal justice pathways (CJPs) for psychosis in general, and ethnic vulnerability to CJPs.
  
  
  METHODS
  Two-year population-based survey of people presenting with a first-episode of psychosis. A total of 481 patients provided information on pathways to psychiatric care. The main outcome was a CJP at first contact compared with other services on the care pathway.
  
  
  RESULTS
  CJPs were more common if there was violence at first presentation (odds ratio (OR) = 4.23, 95% CI 2.74-6.54, P<0.001), drug use in the previous year (OR = 2.28, 95% CI 1.50-3.48, P<0.001) and for high psychopathy scores (OR = 2.54, 95% CI 1.43-4.53, P = 0.002). Compared with White British, CJPs were more common among Black Caribbean (OR = 2.97, 95% CI 1.54-5.72, P<0.001) and Black African patients (OR = 1.95, 95% CI 1.02-3.72, P = 0.01). Violence mediated 30.2% of the association for Black Caribbeans, but was not a mediator for Black African patients. These findings were sustained after adjustment for age, marital status, gender and employment.
  
  
  CONCLUSIONS
  CJPs were more common in violent presentations, for greater psychopathy levels and drug use. Violence presentations did not fully explain ethnic vulnerability to CJPs.
authors: Kamaldeep Bhui, MD, Simone Ullrich, PhD, Constantinos Kallis, PhD, Jeremy W. Coid, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK k.s.bhui@qmul.ac.uk.
authors: Kamaldeep
authors: K
authors: Bhui
authors: Kamaldeep Bhui, MD, Simone Ullrich, PhD, Constantinos Kallis, PhD, Jeremy W. Coid, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors: Simone
authors: S
authors: Ullrich
authors: Kamaldeep Bhui, MD, Simone Ullrich, PhD, Constantinos Kallis, PhD, Jeremy W. Coid, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors: Constantinos
authors: C
authors: Kallis
authors: Kamaldeep Bhui, MD, Simone Ullrich, PhD, Constantinos Kallis, PhD, Jeremy W. Coid, MD, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors: Jeremy W
authors: JW
authors: Coid
mesh_terms: D000328:Adult; D044383:Black People; D003416:Criminal Law / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008131:London / Q000208:ethnology; D008297:Male; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000150:complications* / Q000628:therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data*; D044465:White People; D055815:Young Adult