Ethnic differences in admissions to secure forensic psychiatry services

BackgroundPersons of African – Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour.AimsTo estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services.MethodA 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.ResultsCompulsory 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.ConclusionsVariations 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.