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Management of psychiatric in-patient violence: patient ethnicity and use of medication, restraint and seclusion

  • Gisli H. Gudjonsson (a1), Sophia Rabe-Hesketh (a2) and George Szmukler (a3)
Abstract
Background

Significant ethnic differences have been found previously on a forensic unit in the management of psychiatric patients after a violent incident.

Aims

To study the management of violent incidents on all general wards in a large psychiatric hospital in South London. The main question is whether there are differences in the management of Black patients involved in violent incidents compared with White patients and, if so, what are the factors leading to it?

Method

All recorded violent incidents (1515 in total) on 14 general wards over three years (1994, 1996, 1998) were analysed using mixed logistic regression to estimate the odds ratio that the corresponding management decision (emergency medication, physical restraint, seclusion) was taken for Black patients compared with White patients after controlling for covariates and unobserved heterogeneity between subjects.

Results

Black patients were more likely than White patients to be given emergency medication and to be secluded after a violent incident, but not to be physically restrained. However, differences disappeared when the odds ratios were adjusted for other variables.

Conclusions

Racial ‘stereotyping’ was unlikely to have played a major direct role in determining nurses' responses.

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Copyright
Corresponding author
Correspondence: Professor Gisli H. Gudjonsson, Department of Psychology (PO 78), Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: spjtghg@iop.kcl.ac.uk
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Management of psychiatric in-patient violence: patient ethnicity and use of medication, restraint and seclusion

  • Gisli H. Gudjonsson (a1), Sophia Rabe-Hesketh (a2) and George Szmukler (a3)
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