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Systematic review of racial and ethnic disparities pertaining treatment in mental healthcare amongst incarcerated patients

Published online by Cambridge University Press:  13 August 2021

A. Quintão*
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
M.D. Urzal
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
I. Donas-Boto
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
M.M. Lemos
Affiliation:
Psychiatry, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal
F. Coelho
Affiliation:
Psychiatry, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal
H. Simião
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
N. Moura
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
J. Vian
Affiliation:
Psychiatry Department, Ocidental Lisbon Hospital Center, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

Research has shown that ethnic/racial minorities have a higher risk of homelessness, involvement with the criminal system, psychiatric misdiagnosis, treatment delay, and being prescribed first (versus second) generation antipsychotics.

Objectives

To investigate if the disparities found in the community are replicated in incarcerated patients.

Methods

Systematic review on PubMed for articles that fulfilled criteria for 4 domains: prison, psychosis, race/ethnic, and treatment.

Results

Forty-one articles matched the search criteria. Of those, 24 were irrelevant; 2 were inaccessible. Fifteen articles were considered; most highlighted the interplay between the criminal system, homelessness, mental disorders, and ethnic/racial minorities. Five articles highlighted differences in treatment. One stated that African-Americans and Asians were less likely than Whites to have access to mental health services. Concerning treatment for substance use disorders, one study found Hispanic inmates were more often engaged in treatment, followed by Caucasians and lastly, African-Americans; a different study reported the percentage of Whites and Blacks receiving treatment was similar, while Latinos were under-represented. Whites were most likely to have mental health counseling/substance use treatment as part of their sentence. A study from New-Zealand stated that treatment for mental disorders was less common for Maoris, in whom suicidal thoughts were often unrecognized. The last study reported a higher risk of self-harm for foreign patients, coupled with non-recognition/misinterpretation of symptoms.

Conclusions

Racial/ethnic inequalities show that disparities in healthcare are pervasive in all settings. More studies are needed to better understand the complex nature of this problem.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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