Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-24T01:02:23.341Z Has data issue: false hasContentIssue false
  • English
  • Français

Mistrust of mental health services: ethnicity, hospital admission and unfair treatment

Published online by Cambridge University Press:  17 March 2014

R. C. Henderson ,
P. Williams ,
J. Gabbidon ,
S. Farrelly ,
O. Schauman ,
S. Hatch ,
G. Thornicroft ,
D. Bhugra ,
S. Clement  and
the MIRIAD study group
R. C. Henderson*
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
P. Williams
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
J. Gabbidon
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
S. Farrelly
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
O. Schauman
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
S. Hatch
Affiliation:
Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, UK
G. Thornicroft
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
D. Bhugra
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
S. Clement
Affiliation:
Health Service and Population Research Department, King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: Dr R.C. Henderson, Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims.

To explore the role of psychiatric admission, diagnosis and reported unfair treatment in the relationship between ethnicity and mistrust of mental health services.

Methods.

The Mental Illness-Related Investigations on Discrimination (MIRIAD) study was a cross-sectional study of 202 individuals using secondary mental health services in South London. Two structural equation models were estimated, one using Admission (whether admitted to hospital for psychiatric treatment in the past 5 years) and one using involuntary admission to hospital in the past 5 years.

Results.

Increased mistrust was directly associated with the latent variable ‘unfair treatment by mental health services and staff’ and with Black or mixed ethnicity in both models. Those with a diagnosis of schizophrenia spectrum (as compared to depression and bipolar disorder) had a lower average score on the latent variable, suggesting that on average they reported less unfair treatment. We found evidence of increased reporting of unfair treatment by those who had an admission in the past 5 years, had experienced involuntary admission, and for people of Black of mixed Black and White ethnicity.

Conclusions.

Neither prevalence of schizophrenia spectrum nor rates of hospital admission explained the greater mistrust of mental health services found among people of Black and mixed Black and White ethnicity compared with White ethnicity. Rather, people of Black and mixed Black and white ethnicity may be more likely to experience unfair treatment, generating mistrust; furthermore, this group is more likely to express mistrust even after accounting for reporting of unfair treatment by mental health services and staff.

Keywords

DiscriminationEthnicityInvoluntary psychiatric admissionMistrust
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 3 , June 2015 , pp. 258 - 265
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Afuwape, SA, Craig, TK, Harris, T, Clarke, M, Flood, A, Olajide, D, Cole, E, Leese, M, McCrone, P, Thornicroft, G (2010). The Cares of Life Project (CoLP): an exploratory randomised controlled trial of a community-based intervention for Black people with common mental disorder. Journal of Affective Disorders 127, 370–374.Google Scholar
Ahnquist, J, Wamala, SP, Lindstrom, M (2010). What has trust in the health-care system got to do with psychological distress? Analyses from the national Swedish survey of public health. International Journal of Quality in Health Care 22, 250–258.Google Scholar
Armstrong, K, Putt, M, Halbert, CH, Grande, D, Schwartz, JS, Liao, K, Marcus, N, Demeter, MB, Shea, JA (2013). Prior experiences of racial discrimination and racial differences in health care system distrust. Medical Care 51, 144–150.Google Scholar
Barrett, B, Waheed, W, Farrelly, S, Birchwood, M, Dunn, G, Flach, C, Henderson, C, Leese, M, Lester, H, Marshall, M, Rose, D, Sutherby, K, Szmukler, G, Thornicroft, G, Byford, S (2013). Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: economic outcomes. Plos ONE DOI: 10.1371/journal.pone.0074210 Nov 25.CrossRefGoogle ScholarPubMed
Bhugra, D, Ayonrinde, O, Butler, G, Leese, M, Thornicroft, G (2011). A randomised controlled trial of assertive outreach vs. treatment as usual for Black people with severe mental illness. Epidemiological and Psychiatric Sciences 20, 83–89.Google Scholar
Brohan, E, Slade, M, Clement, S, Rose, D, Sartorius, N, Thornicroft, G (2013). Development and psychometric validation of the Discrimination and Stigma Scale (DISC). Psychiatry Research 208, 33–40.CrossRefGoogle ScholarPubMed
Clement, S, Brohan, E, Jeffery, D, Henderson, C, Hatch, SL, Thornicroft, G (2012). Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health. BMC Psychiatry 12, 36.Google Scholar
Corker, E, Hamilton, S, Henderson, C, Weeks, C, Pinfold, V, Rose, D, Wiliams, P, Flach, C, Gill, V, Thornicroft, G (2013). Experiences of discrimination among people using mental health service users in England 2008–11. British Journal of Psychiatry 202, s58–s63.Google Scholar
Davies, S, Thornicroft, G, Leese, M, Higgingbotham, A, Phelan, M (1996). Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London. British Medical Journal 312, 533–553.CrossRefGoogle Scholar
Evans-Lacko, S, Henderson, C, Thornicroft, G (2013). Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. British Journal of Psychiatry 202, s51–s57.Google Scholar
Fernando, S (1988). Race and Culture in Psychiatry. Tavistock: London.Google Scholar
Harrison, G (2002). Ethnic minorities and the Mental Health Act. British Journal of Psychiatry 180, 198–199.CrossRefGoogle ScholarPubMed
Harrison, G, Holton, A, Neilson, D, Owens, D, Boot, D, Cooper, J (1989). Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychological Medicine 19, 683–696.CrossRefGoogle ScholarPubMed
Hafkenscheid, A (1993). Reliability of a standardized and expanded Brief Psychiatric Rating Scale: a replication study. Acta Psychiatrica Scandinavica 88, 305–310.CrossRefGoogle ScholarPubMed
Keating, F, Robertson, D (2004). Fear, Black people and mental illness. A vicious circle? Health and Social Care in the Community 12, 439–447.Google Scholar
Kessler, RC, Mickelson, KD, Williams, DR (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior 40, 208–230.Google Scholar
Lindstrom, M (2008). Social capital, anticipated ethnic discrimination and self-reported psychological health: a population-based study. Social Science & Medicine 66, 1–13.Google Scholar
Littlewood, R, Lipsedge, M (1997). Aliens and Alienists: Ethnic Minorities and Psychiatry. Routledge: London.Google Scholar
Muthén, LK, Muthén, BO (2013). Mplus User's Guide, 7th edn. Muthén & Muthén: Los Angeles, CA.Google Scholar
Parkman, S, Davies, S, Leese, M, Phelan, M, Thornicroft, G (1997). 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.Google Scholar
Pitarka-Carcani, I, Szmukler, G, Henderson, C (2000). Complaints about care in a mental health trust. Psychiatric Bulletin 24, 372.Google Scholar
Rose, D, Willis, R, Brohan, E, Sartorius, N, Villares, C, Wahlbeck, K, Thornicroft, G (2011). Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiology and Psychiatric Sciences 20, 193–204.Google Scholar
Rubin, D (1976). Inference and missing data. Biometrika 63, 581–592.Google Scholar
Singh, SP, Greenwood, N, White, S, Churchill, R (2007). Ethnicity and the Mental Health Act 1983. British Journal of Psychiatry 191, 99–10.CrossRefGoogle ScholarPubMed
Swanson, JW, Swartz, MS, Elbogen, EB, Van Dorn, R, Ferron, J, Wagner, HR, McCauley, BJ, Kim, M (2006). Facilitated psychiatric advance directives: a randomized trial of an intervention to foster advance treatment planning among persons with severe mental illness. American Journal of Psychiatry 163, 1943–1951.CrossRefGoogle ScholarPubMed
Thornicroft, G, Brohan, E, Rose, D, Sartorius, N, Leese, M (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373, 408–415.CrossRefGoogle ScholarPubMed
Thornicroft, G, Farrelly, S, Szmukler, G, Birchwood, M, Waheed, W, Fiach, C, Barett, B, Byford, S, Henderson, C, Sutherby, K, Lester, H, Rose, D, Dunn, G, Leese, M, Marshall, M (2013). Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: clinical outcomes. Lancet 381, 1634–41.Google Scholar
Verhaeghe, M, Bracke, P (2011). Stigma and trust among mental health service users. Archives of Psychiatric Nursing 25, 294–230.Google Scholar
Williams, DR, Yan, Y, Jackson, JS, Anderson, NB (1997). Racial differences in physical and mental health: socio-economic status, stress and discrimination. Journal of Health Psychology 2, 335–351.Google Scholar
Wilson, M (2009). Delivering Race Equality in Mental Health Care: a Review. Department of Health: London.Google Scholar
Yuan, K, Bentler, P (2000). Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. In Sociological Methodology 2000 (ed. Sobel, ME and Becker, MP), pp. 165–200. ASA: Washington, DC.Google Scholar