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Ethnicity and the Mental Health Act 1983
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Singh, Swaran P., Greenwood, Nan, White, Sarah and Churchill, Rachel. (2007) Ethnicity and the Mental Health Act 1983. British Journal of Psychiatry, Vol.191 . pp. 99-105. ISSN 0007-1250
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Official URL: http://dx.doi.org/10.1192/bjp.bp.106.030346
Abstract
Background Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act 1983. There has been no systematic exploration of differences within and between ethnic groups, nor of the explanations put forward for this excess. Aims To systematically review detention and ethnicity, with meta-analyses of detention rates for BME groups, and to explore the explanations offered for ethnic differences in detention rates. Method Literature search and meta-analysis. Explanations offered were categorised, supporting literature was accessed and the strength of the evidence evaluated. Results In all, 49 studies met inclusion criteria; of these, 19 were included in the meta-analyses. Compared with White patients, Black patients were 3.83 times, BME patients 3.35 times and Asian patients 2.06 times more likely to be detained. The most common explanations related to misdiagnosis and discrimination against BME patients, higher incidence of psychosis and differences in illness expression. Many explanations, including that of racism within mental health services, were not supported by clear evidence. Conclusions Although BME status predicts psychiatric detention in the UK, most explanations offered for the excess detention of BME patients are largely unsupported.
| Item Type: | Journal Article |
|---|---|
| Subjects: | H Social Sciences > HT Communities. Classes. Races R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine > Warwick Medical School |
| Library of Congress Subject Headings (LCSH): | Great Britain. Mental Health Act 1983, Blacks -- Mental health services, Asians -- Mental health services, Discrimination in mental health services, Race discrimination |
| Journal or Publication Title: | British Journal of Psychiatry |
| Publisher: | Royal College of Psychiatrists |
| ISSN: | 0007-1250 |
| Date: | 2007 |
| Volume: | Vol.191 |
| Page Range: | pp. 99-105 |
| Identification Number: | 10.1192/bjp.bp.106.030346 |
| Status: | Peer Reviewed |
| Access rights to Published version: | Open Access |
| Funder: | Great Britain. Dept. of Health (DoH) |
| References: | Anderson, J.B., and Parrot, J. Urgent psychiatric transfers from prison in England and Wales: A prison perspective. Criminal Behaviour and Mental Health, 5(1):34-40, 1995. Audini, B., and Lelliott, P. Age, gender and ethnicity of those detained under Part II of the Mental Health Act 1983. British Journal of Psychiatry, 180:222-226, 2002. Bebbington, P.E.; Feeney, S.T.; Flannigan, C.B.; Glover, G.R.; Lewis, S.W.; and Wing, J.K. Inner London collaborative audit of admissions in two health districts. II: Ethnicity and the use of the Mental Health Act. British Journal of Psychiatry, 165(6):743-759, 1994. Bhui, K. Racism and mental health prejudice and suffering: Kingsley Publishers, 2002. Bhui, K.; Stansfeld, S.; Hull, S.; Priebe, S.; Mole, F.; and Feder, G. Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. British Journal of Psychiatry, 182:105-116, 2003. Burnett, R.; Mallett, R.; Bhugra, D.; Hutchinson, G.; Der, G.; and Leff, J. The first contact of patients with schizophrenia with psychiatric services: social factors and pathways to care in a multi-ethnic population. Psychological Medicine, 29(2):475-483, 1999. Chakraborty, A., and McKenzie, K. Does racial discrimination cause mental illness? British Journal of Psychiatry, 180:475-477, 2002. Churchill, R.; Wall, S.; Hotopf, M.; Buchanan, A.; and Wessely, S. A systematic review of research relating to the Mental Health Act (1983), 1998. Cochrane, R., and Sashidharan, S.P. Mental health and ethnic minorities: A review of the literature and implications for services. , NHS Centre for Reviews and Dissemination/Social Policy Research Unit. University of York 1996. Cole, E.; Leavey, G.; King, M.; Johnson-Sabine, E.; and Hoar, A. Pathways to care for patients with a first episode of psychosis. A comparison of ethnic groups. British Journal of Psychiatry, 167(6):770-776, 1995. DOH. Delivering race equality in mental health care: An action plan for reform inside and outside services and the Government’s response to the Independent inquiry into the death of David Bennett. http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuid ance/PublicationsPolicyAndGuidance, 2005. Dubben, H., and Beck-Bornholdt, H. Systematic review of publication bias in studies on publication bias. British Medical Journal, 331:433-434, 2005. Fernando, S. Race and culture in psychiatry. London: Tavistock, 1988. Goater, N.; King, M.; Cole, E.; Leavey, G.; Johnson-Sabine, E.; Blizard, R.; and Hoar, A. Ethnicity and outcome of psychosis. British Journal of Psychiatry, 175 34-42, 1999. Harrison, G.; Amin, S.; Singh, S.P.; Croudace, T.; and Jones, P. Outcome of psychosis in people of African-Caribbean family origin. Population-based first-episode study. British Journal of Psychiatry, 175:43-49, 1999. Harrison, G.; Holton, A.; Neilson, D.; Owens, D.; Boot, D.; and Cooper, J. Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychological Medicine, 19(3):683-696, 1989. Holloway, F.; Davies, G.; Silverman, M.; and Wainwright, T. How many beds? A survey of needs for treatment and care in an in-patient unit. Bulletin of the Royal College of Psychiatrists, 12:91-94, 1988. Karlsen, S., and Nazroo, J.Y. Relation between racial discrimination, social class, and health among ethnic minority groups. American Journal of Public Health, 92(4):624-631, 2002. King, M.; Cole, E.; Leavey, G.; Hoare, A.; and Johnson-Sabine, E. Incidence of psychotic illness in London:comparison of ethnic groups. British Medical Journal, 309:1115-1119, 1994. Lelliott, P.; Audini, B.; and Duffett, R. Survey of patients from an inner-London health authority in medium secure psychiatric care. British Journal of Psychiatry, 178(1):62-66, 2001. Lepping, P.; Steinart, T.; Gebhardt, R.P.; and Rottgers, H.R. Attitudes of mental health professionals and lay-people towards involuntary admission and treatment in England and Germany - a questionnaire analysis. European Psychiatry, 19(2):91-95, 2004. Lewis, G.; Croft-Jeffreys, C.; and David, A. Are British psychiatrists racist? British Journal of Psychiatry, 157:410-415, 1990. Littlewood, R. Ethnic minorities and the Mental Health Act: patterns of explanation. Bulletin of the Royal College of Psychiatrists, 10:306-308, 1986. Littlewood, R., and Lipsedge, M. Aliens and Alienists: Ethnic minorities and psychiatry. London: Routledge, 1997. Morgan, C.; Mallett, R.; Hutchinson, G.; and Leff, J. Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry. Social Science and Medicine, 58(4):739-752, 2004. Mulder, C.L.; Koopmans, G.T.; and Selten, J.P. Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to the Netherlands. Br J Psychiatry, 188:386-91, 2006. Parkman, S.; Davies, S.; Leese, M.; Phelan, M.; and Thornicroft, G. Ethnic differences in satisfaction with mental health services among representative people with psychosis in south London: PRiSM study 4. British Journal of Psychiatry, 171:260-264, 1997. Riordan, S.; Donaldson, S.; and Humphreys, M. The imposition of restricted hospital orders: Potential effects of ethnic origin. International Journal of Law & Psychiatry, 27 171-177, 2004. Sashidharan, S.P. Institutional racism in British psychiatry. Psychiatric Bulletin, 25 (244):247, 2001. Sashidharan, S.P., and Francis, E. Racism in psychiatry necessitates reappraisal of general procedures and Eurocentric theories. British Medical Journal, 319(7204):254, 1999. Singh, S.P. Social Factors and Schizophrenia and Afro-Carribbeans. Advances in Psychiatric Treatment, 7 291-293, 2001. Singh, S.P., and Burns, T. Race and Mental Illness: There is More to race than Racism. BMJ 333:648-651, 2006. Spector, R. Is there a racial bias in clinicians' perceptions of the dangerousness of psychiatric patients? A review of the literature. Journal of Mental Health, 10(1):5-15, 2001. Steinert, T.; Lepping, P.; Baranyai, R.; Hoffmann, M.; and Leherr, H. Compulsory admission and treatment in schizophrenia: a study of ethical attitudes in four European countries. Soc Psychiatry Psychiatr Epidemiol, 40(8):635-41, 2005. Sterne, J.; Egger, M.; and Smith, G.D. Systematic reviews in health care: Investigating and dealing with publication bias and other biases in meta-analysis. British Medical Journal, 323:101-105, 2001. Szmukler, G., and Holloway, F. Reform of the Mental Health Act. Health or safety? Br J Psychiatry, 177:196-200, 2000. van Os, J.; Castle, D.J.; Takei, N.; Der, G.; and Murray, R.M. Psychotic illness in ethnic minorities: clarification from the 1991 census. Psychological Medicine, 26(1):203-208, 1996. |
| URI: | http://wrap.warwick.ac.uk/id/eprint/3760 |
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