Compulsory admission, criminal justice referral and ethnicity
Apr 6, 2005 - 6:32:00 PM
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It is interesting, and surprising, to note that more African-Caribbean family and friends initially sought help directly from the police than did other ethnic groups. A tendency to heavily stigmatise mental illness in the African-Caribbean community may act as a barrier to help-seeking until crises develop, at which point the risk of police involvement and compulsory admission may be substantially increased.
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By Royal College of Psychiatrists, UK,
[RxPG] Two papers published in the April issue of the British Journal of Psychiatry examine levels of compulsory admission, sources of referral and help-seeking among different ethnic groups. The reported findings are from one of the largest ever studies of first onset psychosis and ethnicity conducted in the UK, the ÆSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study.
Paper 1
The aims were to establish whether African-Caribbean and Black African ethnicity is associated with compulsory admission to hospital in a sample of patients with a first episode of psychosis, drawn from two UK centres, south-east London and Nottingham.
Key Findings
1. African-Caribbean and Black African patients were approximately three times more likely to be compulsorily admitted to hospital at first presentation to mental health services than White British patients.
2. African-Caribbean men were four and a half times more likely to be compulsorily admitted that White British men.
Paper 2
Using the same sample, the aims were to establish whether African-Caribbean and Black African ethnicity is associated with higher levels of criminal justice referrals and lower levels of GP referrals to mental health services.
Key Findings
1. African-Caribbean and Black African patients were over two and a half times more likely to be referred to mental health services by a criminal justice agency than White British patients.
2. African-Caribbean and Black African patients were much less likely to be referred to mental health services by a GP than White British patients.
OVERALL COMMENTS
The findings suggest that factors are operating even during a first episode of psychosis to increase the likelihood of criminal justice involvement in the pathway to care and compulsory admission to hospital for Black patients.
Differences between ethnic groups in diagnosis, levels of unemployment, and social circumstances could not explain the high levels of criminal justice referrals and compulsory admissions, or lower levels of GP referrals, among Black patients.
It is interesting, and surprising, to note that more African-Caribbean family and friends initially sought help directly from the police than did other ethnic groups. A tendency to heavily stigmatise mental illness in the African-Caribbean community may act as a barrier to help-seeking until crises develop, at which point the risk of police involvement and compulsory admission may be substantially increased.
Publication:
Morgan C, Mallett R, Hutchinson G, et al (2005) Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission. Report from the ÆSOP study. British Journal of Psychiatry, 186, 281-289; Morgan C, Mallett R, Hutchinson G, et al (2005) Pathways to care and ethnicity. 2. Source of referral and help-seeking. Report from the ÆSOP study. British Journal of Psychiatry, 186, 290-296.
On the web:
www.rcpsych.ac.uk 
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