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Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis

Author

Listed:
  • Caroline Lawlor
  • Sonia Johnson
  • Laura Cole
  • Louise M. Howard

Abstract

Background : Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. Aim : To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. Method : All women admitted to an acute psychiatric inpatient ward or a women’s crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. Results : Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. Discussion : There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.

Suggested Citation

  • Caroline Lawlor & Sonia Johnson & Laura Cole & Louise M. Howard, 2012. "Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis," International Journal of Social Psychiatry, , vol. 58(1), pages 3-15, January.
  • Handle: RePEc:sae:socpsy:v:58:y:2012:i:1:p:3-15
    DOI: 10.1177/0020764010382369
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    References listed on IDEAS

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    1. Mclean, Carl & Campbell, Catherine & Cornish, Flora, 2003. "African-Caribbean interactions with mental health services in the UK: experiences and expectations of exclusion as (re)productive of health inequalities," Social Science & Medicine, Elsevier, vol. 56(3), pages 657-669, February.
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    1. Barbara Barrett & Waquas Waheed & Simone Farrelly & Max Birchwood & Graham Dunn & Clare Flach & Claire Henderson & Morven Leese & Helen Lester & Max Marshall & Diana Rose & Kim Sutherby & George Szmuk, 2013. "Randomised Controlled Trial of Joint Crisis Plans to Reduce Compulsory Treatment for People with Psychosis: Economic Outcomes," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-11, November.

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