Skip to main content
×
×
Home

Ethnic differences in admissions to secure forensic psychiatry services

  • Jeremy Coid (a1), Nadji Kahtan (a1), Simon Gault (a2) and Brian Jarman (a2)
Abstract
Background

Persons of African – Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour.

Aims

To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services.

Method

A survey was recorded of 3155 first admissions, from 1988 to 1994, from half of England and Wales, with 1991 census data as the denominator adjusted for under-enumeration.

Results

Compulsory admissions for Black males were 5.6 (CI 5.1–6.3) times as high as, and for Asian males were half, those for White males; for Black females, 2.9 (CI 2.4–4.6) times as high and for Asian females one-third of those for White females. Admissions of non-Whites rose over the study period. Patterns of offending and diagnoses differed between ethnic groups.

Conclusions

Variations in compulsory hospitalisation cannot be entirely attributed to racial bias. Community-based services may be less effective in preventing escalating criminal and dangerous behaviour associated with mental illness in African–Caribbeans.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Ethnic differences in admissions to secure forensic psychiatry services
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Ethnic differences in admissions to secure forensic psychiatry services
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Ethnic differences in admissions to secure forensic psychiatry services
      Available formats
      ×
Copyright
Corresponding author
Professor Jeremy W. Coid, Forensic Psychiatry Research Unit, St Bartholomew's Hospital, William Harvey House, West Smithfield, London EC1A 7BE, UK
Footnotes
Hide All

Declaration of interest

None. Funding was provided by the Department of Health.

Footnotes
References
Hide All
Balarajan, R. & Raleigh, V. S. (1992) The ethnic populations of England and Wales: the 1991 census. Health Trends, 24, 113115.
Bhugra, D., Leff, J., Mallett, R. et al (1997) Incidence and outcome of schizophrenia in Whites, African – Caribbeans and Asians in London. Psychological Medicine, 27, 791798.
Bhui, K. (1997) London's ethnic minorities and the provision of mental health services. In London's Mental Health. The Report to the King's Fund London Commission (eds Johnson, S., Ramsay, R., Thornicroft, G., et al). London: King's Fund Publishing.
Coid, J. W. (1992) DSM–III diagnosis in criminal psychopaths: a way forward. Criminal Behaviour and Mental Health, 2, 7894.
Copas, J. (1995) Using crime statistics for prediction. In Interpreting Crime Statistics (ed. Walker, M. A.), pp. 175206. Oxford: Clarendon Press.
Davies, S., Thornicroft, G., Leese, M., et al (1996) Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London. British Medical Journal, 312, 533536.
Donziger, S. R. (1996) The Real War on Crime. The Report of the National Criminal Justice Commission. New York: Harper Perennial.
Harrison, G., Holton, A., Neilson, D., et al (1988) Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors. Psychological Medicine, 19, 683696.
Harrison, G., Glazebrook, C., Brewin, J., et al (1997) Increased incidence of psychotic disorders in migrants from the Caribbean to the United Kingdom. Psychological Medicine, 27, 799806.
Home Office (1992) Race and the Criminal Justice System: A Home Office Publication under Section 95 of the Criminal Justice Act 1991. London: Home Office.
Ineichen, B., Harrison, G. & Boot, D. (1996) Ethnic factors in voluntary and compulsory admissions. Psychological Medicine, 21, 185196.
Jarman, B. (1983) Identification of underprivileged areas. British Medical Journal, 286, 17051709.
McCreadie, R. G., Leese, M., Tilak-Singh, D., et al (1997) Nithsdale, Nunhead, and Norwood: similarity and differences in prevalence of schizophrenia and utilisation of services in rural and urban areas. British Journal of Psychiatry, 170, 3136.
McGovern, D. & Cope, R. (1987) The compulsory detention of males of different ethnic groups, with special reference to offender patients. British Journal of Psychiatry, 150, 505512.
Moodley, P. & Thornicroft, G. (1988) Ethnic group and compulsory detention. Medicine, Science and the Law, 28, 324328.
Murray, K. (1996) The use of beds in medium secure units in England. Journal of Forensic Psychiatry, 7, 504524.
Owens, D., Harrison, G. & Boot, D. (1991) Ethnic factors in voluntary and compulsory admissions. Psychological Medicine, 21, 185196.
Shubsachs, A. P. W., Huws, R. W., Close, A. A., et al (1995) Male Afro-Caribbean patients admitted to Rampton Hospital between 1977–1976 – A controlled study. Medicine, Science and the Law, 35, 336346.
Sillitoe, K. (1987) Asking About Race. London: Office of Population Censuses and Surveys.
Simpson, S., Cossey, R. & Diamond, I. (1997) 1991 population estimates for areas smaller than districts. Population Trends, 90, 3139.
Smith, D. J. (1997) Ethnic origins, crime and criminal justice. In The Oxford Handbook of Criminology (2nd edn) (eds Maguire, M., Morgan, R. & Reiner, R.), pp. 703759. Oxford: Clarendon Press.
Wessely, S. C., Castle, D., Douglas, A. F., et al (1994) The criminal careers of incident cases of schizophrenia. Psychological Medicine, 24, 483502.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Ethnic differences in admissions to secure forensic psychiatry services

  • Jeremy Coid (a1), Nadji Kahtan (a1), Simon Gault (a2) and Brian Jarman (a2)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *