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Ethnic Differences in Mental Health Service Use Among Patients with Psychotic Disorders

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Abstract

Background

There are concerns that ethnic minority patients are over-represented in inpatient mental health settings, but under-utilise community services. This study aims to compare the use of community mental health services between African-Caribbean and White patients with psychosis, before and after the introduction of new community services, and to investigate their impact on inpatient treatment.

Methods

The sample was drawn from epidemiologically representative patients with psychotic disorders living in two catchment areas in South London, one of which was developing intensive community treatments. Service utilisation was measured at baseline and at 2-year follow-up using the Client Service Receipt Interview (CSRI). The mean number of contacts with specific services was compared between the two groups over time.

Results

A total of 92 White and 48 African-Caribbean patients were compared. The latter were more likely to be younger (P = 0.004), have shorter illness duration (P < 0.001), and had more detentions under the Mental Health Act (P = 0.003). No significant differences were seen in use of community services over time. However, intensive treatment led to a significant reduction in hospital days for African Caribbean patients compared to White patients in the intensive sector and all patients in the standard sector.

Conclusions

Intensive community treatments reduced inpatient days in African Caribbean patients. Further effort is needed to improve the cultural sensitivity of community mental health services.

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Acknowledgements

The authors gratefully acknowledge the helpful comments and suggestions from Dr Morven Leese on the methodology and analysis of the data.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Rajesh Mohan MRCPsych.

Additional information

Declaration of interest:

This study was funded by the Bethlem and Maudsley NHS Trustees.

Appendix 1

Appendix 1

Service use categories

Category

Description

Psychiatrist

Appointment with psychiatrist

Emergency clinic

Contact with emergency hospital services

Day care

Day hospital and day care services

CPN

Community psychiatric nurse

Occupational therapist

Occupational therapy appointments

Psychologist

Psychology appointments

General health care

General practitioner and other general health care

Social services

Social worker and other social care services

Allied services

Educational, employment and legal services

Informal care

All informal care

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Mohan, R., McCrone, P., Szmukler, G. et al. Ethnic Differences in Mental Health Service Use Among Patients with Psychotic Disorders. Soc Psychiat Epidemiol 41, 771–776 (2006). https://doi.org/10.1007/s00127-006-0094-7

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  • DOI: https://doi.org/10.1007/s00127-006-0094-7

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