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Pathways to Care for Patients with a First Episode of Psychosis: A Comparison of Ethnic Groups

  • Eleanor Cole (a1), Gerard Leavey (a1), Michael King (a1), Eric Johnson-Sabine (a1) and Amanda Hoar (a2)...

Abstract

Background

It is reported that patients from ethnic minority groups, in particular Afro-Caribbeans, are more likely to enter less desirable pathways to psychiatric care. We aimed to determine whether ethnicity significantly affected time to presentation, type of first contact, rates of compulsory admission and police and primary care involvement, in patients with their first episode of psychosis.

Method

As part of a prospective epidemiological study, patients and their carers were interviewed using a semi-structured questionnaire to trace the various persons and agencies seen en route to their first contact with psychiatric services.

Results

While compulsory admission was more likely for Black patients, the excess was less striking than in previous studies. Black patients were no more likely than other patients to have police involvement. The most important factors in avoiding an adverse pathway were having a supportive family member or friend and the presence of a general practitioner to assist in gaining access to psychiatric services.

Conclusions

The routes to psychiatric services for first onset patients are different to those for chronic patients. Variables associated with social support were more important than ethnicity in determining pathways to care. Police involvement and compulsory admissions were strongly associated with the absence of GP involvement and the absence of help-seeking by a friend or relative. It may be that ethnicity becomes an important variable after the patient has come into contact with psychiatric services.

Copyright

Corresponding author

Dr Cole, St Ann's Hospital, St Ann's Road, London N15 3TH

References

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Pathways to Care for Patients with a First Episode of Psychosis: A Comparison of Ethnic Groups

  • Eleanor Cole (a1), Gerard Leavey (a1), Michael King (a1), Eric Johnson-Sabine (a1) and Amanda Hoar (a2)...
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