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Emergency psychiatry, compulsory admissions and clinical presentation among immigrants to The Netherlands

University Medical Centre Rotterdam, Department of Psychiatry, Rotterdam, Mental Helath Group Europoort, Barendrecht, and Municipal Health Centre Rotterdam and surroundings, Rotterdam

GERRIT T. KOOPMANS, MSc, Erasmus MC

University Medical Centre Rotterdam, Department of Health Policy and Management, Rotterdam

JEAN-PAUL SELTEN, MD

Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands

Correspondence: Dr C. L. Mulder, Mental Health Group Europoort, PO Box 245, 2990 AE Barendrecht, The Netherlands. Tel: +31180 643500; e-mail: niels.clmulderniels.clmulder{at}wxs.nl

Declaration of interest None. Funding detailed in Acknowledgements.

Background Black individuals in the UK have higher rates of contact with psychiatric emergency services than their White counterparts. It is unknown whether this is also the case in other European countries.

Aims To compare the risk of contact with psychiatric emergency services and of compulsory admission between immigrant groups to The Netherlands and Dutch natives, and to determine the unique contribution of ethnicity to compulsory admission.

Method Study of 720 people referred to emergency psychiatric services in Greater Rotterdam, The Netherlands.

Results The relative risks (RRs) for contacts with psychiatric emergency services, for having a psychotic disorder and for compulsory admission were significantly higher in most immigrant groups. Moroccans, Surinamese and Dutch Antilleans had the highest risks of compulsory admission. After controlling for symptom severity, danger, motivation for treatment and level of social functioning, non-Western origin was no longer associated with compulsory admission.

Conclusions Non-Western immigrant groups were overrepresented in psychiatric emergency care and were admitted compulsorily more frequently, possibly owing to a different clinical presentation.

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