Psychiatric morbidity and compulsory admission among UK-born Europeans, Afro - Caribbeans and Asians in central Manchester

Psychaitry admissions in Central Manchester of Europeans, Afro-Caribbeans, and Asians (within three age-bands) were studied over four years. Among the Afro-Caribbean group there were more single or unemployed persons than in either the Asian or European groups, which suggested greater socio-economic disadvantages. Rates for first admissions and readmissions among Afro-Caribbeans were greater; among Asians they were similar except for the 16-29-year age-group, who tended to have lower rates than Europeans. A higher proportion of Afro-Caribbean and Asians were psychotic. In the Afro-Caribbean group, the raised rates of admission were largely attributable to increase rates of schizophrenia. The highest rate occurred in second-generation (UK-born) Afro-Caribbeans and was nine times that among Europeans. The police were more frequently involved in the admissions of Afro-Caribbean compared with Europeans or Asians. Higher proportions of Afro-Caribbeans and Asians who were readmitted were detained under the Mental Health Act 1983, when compared with Europeans (AU)

Attitudes of relatives of Afro-Caribbean patients: do they affect admission?

This pilot study explored suggestions made in the literature that high rates of Afro-Caribbean patients compulsorily admitted to hospital can be explained by the attitudes of relatives. In particular relatives who hold negative attitudes towards psychiatric services and adopt non-medical explanations for the onset of illness might delay in contacting hospital services. This could delay the process of admission and make a compulsory admission more likely. The attitudes and experiences of relatives of 15 patients admitted compulsorily and 10 admitted informally were compared. The relatives' attitudes did not differ between the two groups. There was also no difference in the severity of current symptoms of the relative's assessment of dangerousness. Neither group was characterised by the sorts of attitudes to illness that had been hypothesised

Severe mental disorder in Afro-Caribbean patients: some social, demographic and service factors

Forty-two consecutively identified Afro-Caribbean patients with a first episode of psychosis were compared with a similar group of non-Caribbean patients. A number of differences emerged, although the same portion of patients in each group had symptoms for 6 months or more prior to psychiatric contact. Afro-Caribbean patients showed greater delay in seeking help, more `disturbance' later in the course of their illness and were more likely to be admitted compulsorily. The social geography of the two groups suggests that the high rates of schizophrenia and related psychoses that we previously reported cannot be explained simply by differences in area of residence at the time of presentation. (AU)

Ethnic groups and compulsory detention

One hundred consecutive patients detained under the Mental Health Act (1983) were investigated in terms of ethnicity, socio-demographic characteristics, psychiatric diagnosis, reasons for compulsary detention and immediate managment. Of the total group, 26 were of West Indian origin and 26 were white. West Indian patients were more likely to be young, referred by the police, and detained because of violence. Schizophrenia was diagnosed much less frequently among the West Indian male patients. (AU)