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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])
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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 

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