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The British Journal of Psychiatry (2005) 186: 281-289
© 2005 The Royal College of Psychiatrists

Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission

Report from the ÆSOP study{dagger}

CRAIG MORGAN, PhD and ROSEMARIE MALLETT, PhD

Division of Psychological Medicine, Institute of Psychiatry, London, UK

GERARD HUTCHINSON, MRCPsych

Psychiatry Unit, Department of Clinical Medical Sciences, University of the West Indies, Trinidad

HEMANT BAGALKOTE, MRCPsych

Department of Psychiatry, University of Nottingham, Nottingham

KEVIN MORGAN, PhD, PAUL FEARON, MRCPsych, PAOLA DAZZAN, MRCPsych and JANE BOYDELL, MRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London

KWAME McKENZIE, MRCPsych

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London

GLYNN HARRISON, FRCPsych

Division of Psychiatry, University of Bristol, Bristol

ROBIN MURRAY, FRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London

PETER JONES, FRCPsych

Department of Psychiatry, University of Cambridge, Cambridge

TOM CRAIG, FRCPsych and JULIAN LEFF, FRCPsych

Division of Psychological Medicine, Institute of Psychiatry, London, UK

on behalf of the ÆSOP Study Group

Correspondence: Dr Craig Morgan, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.Tel: +44 (0)20 7848 0351; e-mail spjucrm{at}iop.kcl.ac.uk

Declaration of interest None.

{dagger} See Part 2, pp. 290–296, this issue.

Background Many studies have found high levels of compulsory admission to psychiatric hospital in the UK among African–Caribbean and Black African patients with a psychotic illness.

Aims To establish whether African–Caribbean and Black African ethnicity is associated with compulsory admission in an epidemiological sample of patients with a first episode of psychosis drawn from two UK centres.

Method All patients with a firstepisode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas were included in the (ÆSOP) study. For this analysis we included all White British, other White, African–Caribbean and Black African patients from the ÆSOP sampling frame. Clinical, socio-demographic and pathways to care data were collected frompatients, relatives and case notes.

Results African–Caribbean patients were significantly more likely to be compulsorily admitted than White British patients, as were Black African patients. African–Caribbean men were the most likely to be compulsorily admitted.

Conclusions These findings suggest that factors are operating at or prior to first presentation to increase the risk of compulsory admission among African–Caribbean and Black African patients.




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