Associations between attachment, therapeutic alliance, and engagement in black people with psychosis living in the UK

This article explores the place of ‘ethnicity’ in the operation, management and contestation of the UK National DNA Database (NDNAD). In doing so, it examines the limitations of bioethics as a response to political questions raised by the new genetics. The UK police forensic database has been racialised in a number of distinct ways: in the over-representation of black people in the database population; in the classification of all DNA profiles according to ‘ethnic appearance’; in the use of data for experiments to determine the ethnicity of crime scene DNA; and in the focus on ethnicity in public debate about the database. This racialisation presented potential problems of legitimacy for the NDNAD but, as the article shows, these have been partly neutralised through systems of ethico-political governance. In these systems of governance discussion of institutional racism has been postponed or displaced by other ways of talking about ethnicity and identity.

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Physical health monitoring in dementia and associations with ethnicity: a descriptive study using electronic health records

BJGP Open ◽

10.3399/bjgpopen20x101080 ◽

2020 ◽

Vol 4 (4) ◽

pp. bjgpopen20X101080

Author(s):

Cini Bhanu ◽

Mary Elizabeth Jones ◽

Kate Walters ◽

Irene Petersen ◽

Jill Manthorpe ◽

...

Keyword(s):

Primary Care ◽

Physical Health ◽

Influenza Vaccination ◽

Ethnic Groups ◽

Health Monitoring ◽

Black People ◽

Good Care ◽

People With Dementia ◽

The Uk ◽

Comorbidity Status

BackgroundGood physical health monitoring can increase quality of life for people with dementia, but the monitoring may vary and ethnic inequalities may exist.AimTo investigate UK primary care routine physical health monitoring for people with dementia by: (a) ethnic groups, and (b) comorbidity status.Design & settingA retrospective cohort study was undertaken using electronic primary care records in the UK.MethodPhysical health monitoring was compared in people with dementia from white, black, and Asian ethnic groups and compared those with ≥1 comorbidity versus no comorbidity, from 1 April 2015 to 31 March 2016. Using the Dementia:Good Care Planning framework and expert consensus, good care was defined as receiving, within 1 year: a dementia review; a blood pressure (BP) check (at least one); a GP consultation (at least one); a weight and/or body mass index (BMI) recording (at least one); and an influenza vaccination.ResultsOf 20 821 people with dementia, 68% received a dementia review, 80% at least one BP recording, 97% at least one GP contact, 48% a weight and/or BMI recording, and 81% an influenza vaccination in 1 year. Compared with white people, black people were 23% less likely and Asian people 16% less likely to have weight recorded (adjusted incidence rate ratio [IRR] = 0.77, 95% confidence interval [CI] = 0.60 to 0.98/0.84, 0.71 to 1.00). People without comorbidities were less likely to have weight recorded (adjusted IRR = 0.74, 95% CI = 0.69 to 0.79) and BP monitored (adjusted IRR = 0.71, 95% CI = 0.68 to 0.75).ConclusionEthnic group was not associated with differences in physical health monitoring, other than weight monitoring. Comorbidity status was associated with weight and BP monitoring. Physical health monitoring in dementia, in particular nutrition, requires improvement.

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Ethnicity and outcome of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.175.1.34 ◽

1999 ◽

Vol 175 (1) ◽

pp. 34-42 ◽

Cited By ~ 52

Author(s):

Nicky Goater ◽

Michael King ◽

Eleanor Cole ◽

Gerard Leavey ◽

Eric Johnson-Sabine ◽

...

Keyword(s):

Ethnic Groups ◽

Black People ◽

Incidence Rates ◽

Psychotic Illness ◽

Term Outcome ◽

Cross Sectional ◽

Long Term Outcome ◽

Course Of Illness ◽

The Uk ◽

Asian People

BackgroundAn excess of psychotic illness in Black people has been found in cross-sectional studies. Little is known about the outcome of psychosis in different ethnic groups in the UK.AimsTo compare the incidence, nature and long-term outcome of psychosis in different ethnic groups.MethodA five-year, prospective study of an epidemiological cohort of people with a first contact for psychosis.ResultsAge-standardised incidence rates for schizophrenia and non-affective psychosis were higher for Black and Asian people than Whites. Stability of diagnosis and course of illness were similar in all ethnic groups. During the fifth year, Black people were more likely than others to be detained, brought to hospital by the police and given emergency injections.ConclusionsThe nature and outcome of psychotic illness is similar in all ethnic groups but Black people experience more adverse contacts with services later in the course of illness.

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Perceptions of disadvantage, ethnicity and psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.042291 ◽

2008 ◽

Vol 192 (3) ◽

pp. 185-190 ◽

Cited By ~ 50

Author(s):

Claudia Cooper ◽

Craig Morgan ◽

Majella Byrne ◽

Paola Dazzan ◽

Kevin Morgan ◽

...

Keyword(s):

Ethnic Groups ◽

Black People ◽

Religious Affiliation ◽

Population Based ◽

First Episode ◽

Black African ◽

Episode Psychosis ◽

African Caribbean ◽

The Uk ◽

Control Study

BackgroundPeople from Black ethnic groups (African-Caribbean and Black African) are more prone to develop psychosis in Western countries. This excess might be explained by perceptions of disadvantage.AimsTo investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage.MethodA population-based incidence and case-control study of first-episode psychosis (Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP)). A total of 482 participants answered questions about perceived disadvantage.ResultsBlack ethnic groups had a higher incidence of psychosis (OR=4.7, 95% CI 3.1–7.2). After controlling for religious affiliation, social class and unemployment, the association of ethnicity with psychosis was attenuated (OR=3.0, 95% CI 1.6–5.4) by perceptions of disadvantage. Participants in the Black non-psychosis group often attributed their disadvantage to racism, whereas Black people in the psychosis group attributed it to their own situation.ConclusionsPerceived disadvantage is partly associated with the excess of psychosis among Black people living in the UK. This may have implications for primary prevention.

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Plumbing the Depths: The Changing (Socio-Demographic) Profile of UK Poverty

Journal of Social Policy ◽

10.1017/s0047279421000180 ◽

2021 ◽

pp. 1-27

Author(s):

DANIEL EDMISTON

Keyword(s):

Black People ◽

Poverty Line ◽

Poverty Measurement ◽

Full Time ◽

Demographic Profile ◽

The Poor ◽

The Social ◽

Time Work ◽

Social Scientific ◽

The Uk

Abstract Official statistics tend to rely on a headcount approach to poverty measurement, distinguishing ‘the poor’ from the ‘non-poor’ on the basis of an anchored threshold. Invariably, this does little to engage with the gradations of material hardship affecting those living, to varying degrees, below the poverty line. In response, this paper interrogates an apparent flatlining in UK poverty to establish the changing profile of poverty, as well as those most affected by it. Drawing on the Family Resources survey, this paper reveals an increasing depth of poverty in the UK since 2010, with bifurcation observable in the living standards of different percentile groups below the poverty line. In addition, this paper demonstrates substantial compositional changes in the socio-demographic profile of (deep) poverty. Since 2010, the likelihood of falling into deep poverty has increased for women, children, larger families, Black people and those in full-time work. Within the context of COVID-19, I argue there is a need to re-think how we currently conceptualise poverty by better attending to internal heterogeneity within the broader analytical and methodological category of ‘the poor’. Doing so raises pressing questions about the prevailing modes of poverty measurement that tend to frame and delimit the social scientific analysis of poverty, as well as the policies deemed appropriate in tackling it.

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Does ethnicity influence dementia, stroke and mortality risk? Evidence from the UK Biobank

10.21203/rs.3.rs-689280/v1 ◽

2021 ◽

Author(s):

Bruno Bonnechère ◽

Jun Liu ◽

Alexander Thomson ◽

Najaf Amin ◽

Cornelia van Duijn

Keyword(s):

Risk Factors ◽

Black People ◽

Final Analysis ◽

Uk Biobank ◽

White People ◽

People With Dementia ◽

Risk Of Mortality ◽

Increased Risk ◽

The Difference ◽

The Uk

Abstract The number of people with dementia and stroke, which are heritable diseases, is increasing worldwide. There is increasing evidence that there are clinically relevant genetic differences across ethnicities. This study aims to quantify risk factors of dementia, stroke, and mortality in Asian and black participants compared to whites. 272,660 participants from the UKBiobank were included in the final analysis, among whom the vast majority are white (97.80%), followed by Asian (1.35%), and black (0.84%) participants. After adjusting for risk factors, black participants have an increased risk of dementia and stroke compared to whites participants, while Asians did not. The risk of mortality is not different in blacks and white participants but Asians have a decreased risk. This study highlights the difference in the risk of dementia and stroke in black people living in the UK compared to white people.

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Therapeutic communities

Advances in Psychiatric Treatment ◽

10.1192/apt.7.5.365 ◽

2001 ◽

Vol 7 (5) ◽

pp. 365-372 ◽

Cited By ~ 53

Author(s):

Penelope Campling

Keyword(s):

Decision Making ◽

Therapeutic Alliance ◽

Therapeutic Community ◽

Peer Group ◽

Personal Responsibility ◽

Collective Responsibility ◽

Therapeutic Communities ◽

Therapeutic Work ◽

Therapeutic Setting ◽

The Uk

The term ‘therapeutic community’ is usually used in the UK to describe small cohesive communities where patients (often referred to as residents) have a significant involvement in decision-making and the practicalities of running the unit. Based on ideas of collective responsibility, citizenship and empowerment, therapeutic communities are deliberately structured in a way that encourages personal responsibility and avoids unhelpful dependency on professionals. Patients are seen as bringing strengths and creative energy into the therapeutic setting, and the peer group is seen as all-important in establishing a strong therapeutic alliance. The flattened hierarchy and delegated decision-making are sometimes misunderstood as anarchy by outsiders. However, staff in modern therapeutic communities are deeply aware of the need for strong leadership and their responsibility to provide a safe ‘frame’ for therapeutic work (Association of Therapeutic Communities, 1999).

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What attitudes do psychiatrists hold towards people with mental illness?

Psychiatric Bulletin ◽

10.1192/pb.28.11.401 ◽

2004 ◽

Vol 28 (11) ◽

pp. 401-406 ◽

Cited By ~ 44

Author(s):

David Kingdon ◽

Tonmoy Sharma ◽

Deborah Hart ◽

Keyword(s):

Mental Illness ◽

General Population ◽

Social Workers ◽

Antipsychotic Medication ◽

Royal College ◽

Black People ◽

Clinical Implications ◽

National Formulary ◽

People With Mental Illness ◽

The Uk

Aims and MethodTo investigate the attitudes that psychiatrists hold towards people with mental illness. Each member of the Royal College of Psychiatrists in the UK was sent a questionnaire based on previous research in this area, supplemented with relevant questions on management.Results2813 of 6524 questionnaires were returned (43%). Psychiatrists' attitudes compared favourably with those of the general population. Among other findings, they believed that the risk of dangerousness was overemphasised, that misdiagnosis of schizophrenia in Black people is common, and that polypharmacy and the use of antipsychotic medication above British National Formulary levels occurs too often.Clinical ImplicationsPsychiatrists' attitudes are substantially more favourable towards people with mental illness than those of the general population with individual, but important, exceptions. Some aspects of psychiatric management, especially of antipsychotic medication, may undermine this, however. Comparison with other groups, e.g. general practitioners, nurses and social workers, would be useful in planning how to reduce the stigmatisation of people with mental illness.

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Black people and psychiatry in the UK

Psychiatric Bulletin ◽

10.1192/pb.13.9.482 ◽

1989 ◽

Vol 13 (9) ◽

pp. 482-485 ◽

Cited By ~ 29

Author(s):

Errol Francis ◽

Jack David ◽

Nancy Johnson ◽

S. P. Sashidharan

Keyword(s):

Detailed Analysis ◽

Theoretical Basis ◽

Current Practice ◽

Minority Groups ◽

Black People ◽

Black Experience ◽

Current Topic ◽

Institutional Psychiatry ◽

Black Struggle ◽

The Uk

Our aim in this paper is to examine the current practice of psychiatry in relation to race or ethnicity in England. The problems that European psychiatry has in relation to black people in a white and predominantly racist society and the responses to these from within the professional sphere are only one aspect of our current topic. We merely mention these to contextualise the problems black people experience as a result of institutional psychiatry. Our main aim in this paper is to articulate the oppression black people experience in relation to conventional psychiatry and to seek ways of confronting and changing this, very much as part of the larger, black struggle in the UK. We believe that the alternative that we propose, based on black experience of psychiatry, is equally valid in other contexts where questions of disadvantage and discrimination are the overriding themes. Although the theoretical basis of our work is grounded on issues such as inequality and structural oppression and the need to confront and change them, a detailed analysis of these topics is beyond the scope of this paper. Instead, we examine the practice of professional psychiatry in relation to black people in the UK and argue that the model that is imposed on us is antithetical to the interests of black minority groups. We also look at practical ways in which our community is beginning to organise in challenging such professional orthodoxy.

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