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Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry

Author

Listed:
  • Morgan, Craig
  • Mallett, Rosemarie
  • Hutchinson, Gerard
  • Leff, Julian

Abstract

It has been consistently reported that the African-Caribbean population in the UK are more likely than their White counterparts to access psychiatric services via the police and under compulsion. The reasons for these differences are poorly understood. This paper comprises two main parts. The first provides a comprehensive review of research in this area, arguing the current lack of understanding stems from a number of methodological limitations that characterise the research to date. The issue of ethnic variations in pathways to psychiatric care has been studied almost exclusively within a medical epidemiological framework, and the potential insights offered by sociological and anthropological research in the fields of illness behaviour and health service use have been ignored. This has important implications as the failure of research to move beyond enumerating differences in sources of referral to psychiatric services and rates of compulsory admission means no recommendations for policy or service reform have been developed from the research. The second part of the paper sets out the foundations for future research, arguing that the pathway to care has to be studied as a social process subject to a wide range of influences, including the cultural context within which illness is experienced. It is further argued that Kleinman's (Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine and psychiatry, University of California Press, Los Angeles, 1980) Health Care System model offers a particularly valuable preliminary framework for organising and interpreting future research. It is only through gaining a more qualitative understanding of the processes at work in shaping different responses to mental illness and interactions with mental health services that the patterns observed in quantitative studies can be fully understood. This further reflects the need for a bridge between the social sciences and psychiatry if services are to be developed to respond to the increasing diversity of modern societies.

Suggested Citation

  • Morgan, Craig & Mallett, Rosemarie & Hutchinson, Gerard & Leff, Julian, 2004. "Negative pathways to psychiatric care and ethnicity: the bridge between social science and psychiatry," Social Science & Medicine, Elsevier, vol. 58(4), pages 739-752, February.
  • Handle: RePEc:eee:socmed:v:58:y:2004:i:4:p:739-752
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    Cited by:

    1. Ilaria Tarricone & Elisa Stivanello & Silvia Ferrari & Niccolò Colombini & Emilio Bolla & Mauro Braca & Cinzia Giubbarelli & Chiara Costantini & Sara Cazzamalli & Stefano Mimmi & Dario Tedesco & Marc, 2012. "Migrant pathways to community mental health centres in Italy," International Journal of Social Psychiatry, , vol. 58(5), pages 505-511, September.
    2. Ilaria Tarricone & Anna Rita Atti & Mauro Braca & Graziano Pompei & Michela Morri & Francesca Poggi & Saverio Melega & Elisa Stivanello & Lorenza Tonti & Maria Nolet & Domenico Berardi, 2011. "Migrants referring to the Bologna Transcultural Psychiatric Team: Reasons for drop-out," International Journal of Social Psychiatry, , vol. 57(6), pages 627-630, November.
    3. Anitha Jeyagurunathan & Edimansyah Abdin & Saleha Shafie & Peizhi Wang & Sherilyn Chang & Hui Lin Ong & Restria Fauziana Abdul Rahman & Vathsala Sagayadevan & Ellaisha Samari & Yi Chian Chua & Janhavi, 2018. "Pathways to care among psychiatric outpatients in a tertiary mental health institution in Singapore," International Journal of Social Psychiatry, , vol. 64(6), pages 554-562, September.
    4. Gila Schnitzer & Gerrit Loots & Valentin Escudero & Isaac Schechter, 2011. "Negotiating the Pathways Into Care in a Globalizing World: Help-Seeking Behaviour of Ultra-Orthodox Jewish Parents," International Journal of Social Psychiatry, , vol. 57(2), pages 153-165, March.
    5. Lawrence, Vanessa & McCombie, Catherine & Nikolakopoulos, Georgios & Morgan, Craig, 2021. "Navigating the mental health system: Narratives of identity and recovery among people with psychosis across ethnic groups," Social Science & Medicine, Elsevier, vol. 279(C).

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