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Ethnicity as a predictor of detention under the Mental Health Act

Published online by Cambridge University Press:  24 June 2013

S. P. Singh ,
T. Burns ,
P. Tyrer ,
Z. Islam ,
H. Parsons  and
M. J. Crawford
S. P. Singh*
Affiliation:
Mental Health and Wellbeing, Warwick Medical School, Coventry, UK
T. Burns
Affiliation:
University of Oxford, Warneford Hospital, Oxford, UK
P. Tyrer
Affiliation:
Imperial College London, Claybrook Centre, London, UK
Z. Islam
Affiliation:
Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
H. Parsons
Affiliation:
Division of Health Sciences, Warwick Medical School, UK
M. J. Crawford
Affiliation:
Imperial College London, Claybrook Centre, London, UK
*
*Address for correspondence: S. P. Singh, Mental Health and Wellbeing, Warwick Medical School, Coventry CV4 7AL, UK. (Email: [email protected])
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Abstract

Background

There has been major concern about the ‘over-representation’ of Black and ethnic minority groups amongst people detained under the Mental Health Act (MHA). We explored the effect of patient ethnicity on detention following an MHA assessment, once confounding variables were controlled for.

Method

Prospective data were collected for all MHA assessments over 4-month periods in the years 2008, 2009, 2010 and 2011 each in three regions in England: Birmingham, West London and Oxfordshire. Logistic regression modelling was conducted to predict the outcome of MHA assessments – either resulting in ‘detention’ or ‘no detention’.

Results

Of the 4423 MHA assessments, 2841 (66%) resulted in a detention. A diagnosis of psychosis, the presence of risk, female gender, level of social support and London as the site of assessment predicted detention under the MHA. Ethnicity was not an independent predictor of detention.

Conclusions

There is no evidence for that amongst those assessed under the MHA, ethnicity has an independent effect on the odds of being detained.

Keywords

Coercionethnic minorityMental Health Actpsychosisrisktranscultural psychiatry
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 5 , April 2014 , pp. 997 - 1004
Copyright
Copyright © Cambridge University Press 2013 

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References

Banerjee, S, O'Neill-Byrne, K, Exworthy, T, Parrott, J (1995). The Belmarsh Scheme. A prospective study of the transfer of mentally disordered remand prisioners from prison to psychiatric units. British Journal of Psychiatry 166, 802–805.Google Scholar
Bebbington, PE, Feeney, ST, Flannigan, CB, Glover, GR, Lewis, SW, Wing, JK (1994). 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, 743–759.Google Scholar
Bennewith, O, Amos, T, Lewis, G, Katsakou, C, Wykes, T, Morriss, R, Priebe, S (2010). Ethnicity and coercion among involuntarily detained psychiatric in-patients. British Journal of Psychiatry 196, 75–76.Google Scholar
Bhui, K, Stansfeld, S, Hull, S, Priebe, S, Mole, F, Feder, G (2003). Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. British Journal of Psychiatry 182, 105–116.Google Scholar
Burnett, R, Mallett, R, Bhugra, D, Hutchinson, G, Der, G, Leff, J (1999). The first contact of patients with schizophrenia with psychiatric services: social factors and pathways to care in a multi-ethnic population. Psychological Medicine 29, 475–483.Google Scholar
Churchill, R, Wall, S, Hotopf, M, Buchanan, A, Wessely, S (1999). A systematic review of research relating to the Mental Health Act (1983). Department of Health (www.health.wa.gov.au/mhareview/resources/documents/Systematic_Review_of_MH_Legislation.pdf). Accessed 19 April 2003.Google Scholar
Claassen, D, Ascoli, M, Berhe, T, Priebe, S (2005). Research on mental disorders and their care in immigrant populations: a review of publications from Germany, Italy and the UK. European Psychiatry 20, 540–549.CrossRefGoogle ScholarPubMed
Cole, E, Leavey, G, King, M, Johnson-Sabine, E, Hoar, A (1995). Pathways to care for patients with a first episode of psychosis. A comparison of ethnic groups. British Journal of Psychiatry 167, 770–776.Google Scholar
Compton, MT, Esterberg, ML, Druss, BG, Walker, EF, Kaslow, NJ (2006). A descriptive study of pathways to care among hospitalized urban African American first-episode schizophrenia-spectrum patients. Social Psychiatry Psychiatric Epidemiology 41, 566–573.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. BMJ 312, 533–537.Google Scholar
Dunn, J, Fahy, TA (1990). Police admissions to a psychiatric hospital. Demographic and clinical differences between ethnic groups. British Journal of Psychiatry 156, 373–378.Google Scholar
Keown, P, Weich, S, Bhui, KS, Scott, J (2011). Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988–2008: ecological study. BMJ 343, d3736.Google Scholar
Lawlor, C, Johnson, S, Cole, L, Howard, LM (2012). Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis. International Journal of Social Psychiatry 58, 3–15.Google Scholar
Lay, B, Nordt, C, Rössler, W (2007). Mental hospital admission rates of immigrants in Switzerland. Social Psychiatry and Psychiatric Epidemiology 42, 229–236.Google Scholar
Maden, A, Friendship, C, McClintock, T, Rutter, S (1999). Outcome of admission to a medium secure psychiatric unit. 2. Role of ethnic origin. British Journal of Psychiatry 175, 317–321.Google Scholar
McKenzie, K, Bhui, K (2007). Institutional racism in mental health care. British Medical Journal 334, 649–650.CrossRefGoogle ScholarPubMed
Morgan, C, Mallett, R, Hutchinson, G, Bagalkote, H, Morgan, K, Fearon, P, Dazzan, P, Boydell, J, McKenzie, K, Harrison, G, Murray, K, Jones, P, Craig, T, Leff, J; AESOP Study Group (2005). Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission. Report from the AESOP study. British Journal of Psychiatry 186, 281–289.Google Scholar
Morgan, C, Mallett, R, Hutchinson, G, Leff, J (2004). Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry. Social Science and Medicine 58, 739–752.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
Patel, K, Heginbotham, C (2007). Race equality, human rights and mental health legislation: recent developments in England and Wales. South African Journal of Psychiatry 13, 76–78.Google Scholar
Priebe, S, Katsakou, C, Amos, T, Leese, M, Morriss, R, Rose, D, Wykes, T, Yeeles, K (2009). Patients’ views and readmissions 1 year after involuntary hospitalisation. British Journal of Psychiatry 194, 49–54.Google Scholar
Singh, SP, Burns, T (2006). Race and mental illness: there is more to race than racism. BMJ 333, 648–651.Google Scholar
Singh, SP, Croudace, T, Beck, A, Harrison, G (1998). Perceived ethnicity and the risk of compulsory admission. Social Psychiatry and Psychiatric Epidemiology 33, 39–44.Google Scholar
Singh, SP, Greenwood, N, White, S, Churchill, R (2007). Ethnicity and the mental health act 1983. British Journal of Psychiatry 191, 99–105.Google Scholar
Swanson, J, Swartz, M, Van Dorn, RA, Monahan, J, McGuire, TG, Steadman, HJ, Robbins, PC (2009). Racial disparities in involuntary outpatient commitment: are they real? Health Affairs (Millwood) 28, 816–826.Google Scholar
The Sainsbury Centre for Mental Health (2002). Breaking the Circles of Fear: A Review of the Relationship Between Mental Health Services and African and Caribbean Communities. The Sainsbury Centre for Mental Health: London.Google Scholar
Vinkers, DJ, de Vries, SC, Van Baars, AW, Mulder, CL (2010). Ethnicity and dangerousness criteria for court ordered admission to a psychiatric hospital. Social Psychiatry and Psychiatric Epidemiology 45, 221–224.Google Scholar