The British Journal of Psychiatry (2006) 188: 380-385. doi: 10.1192/bjp.188.4.380
© 2006 The Royal College of Psychiatrists
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Ethnic differences among patients in high-security psychiatric hospitals in England

MORVEN LEESE, PhD and GRAHAM THORNICROFT, FRCPsych, PhD, FMedSci

Health Service Research Department, Institute of Psychiatry, King’s College London, London

JENNY SHAW, MRCPsych, PhD

Department of Psychiatry, University of Manchester, Manchester

STUART THOMAS, BA, LLM, RAJESH MOHAN, MRCPsych and MARI ANNE HARTY, MSc, MRCPsych

Health Service Research Department, Institute of Psychiatry, King’s College London, London

MAIREAD DOLAN, MRCPsych, PhD

Edenfield Centre, Mental Health Services for Salford, Manchester, UK

Correspondence: Professor GrahamThornicroft, Section of Community Psychiatry (PRiSM), Institute of Psychiatry, King’s College London, De Crespigny Park, London SE5 8AF, UK. Tel: ++44 (0)20 7848 0735; fax: +44 (0)20 7277 1462; e-mail: g.thornicroft{at}iop.kcl.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background Black (Black Caribbean and Black African) patients are over-represented in admissions to general adult and medium-security psychiatric services in England.

Aims To describe the sociodemographic, clinical and offence characteristics of patients in high-security psychiatric hospitals (HSPHs) in England, and to compare admission rates and unmet needs by ethnic group.

Method A total of 1255 in-patients were interviewed, and their legal status, socio-demographic characteristics and individual treatment needs were assessed.

Results Black patients in HSPHs are over-represented by 8.2 times (range 3.2–24.4,95% CI 7.1–9.3), are more often male (P=0.037), and are more often diagnosed with a mental illness and less often diagnosed with a personality disorder or learning disability (P<0.001) than White patients. Unmet needs were significantly less common among White than among Black patients (mean values of 2.22 v. 2.62, difference=0.40,95% CI 0.06–0.73).

Conclusions Compared with the proportion of Black patients in the general population in their region of origin, a much higher proportion of Black patients were admitted to HSPHs, and fewer of their needs were met.


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