scholarly journals Criminal justice pathways to psychiatric care for psychosis

2015 ◽  
Vol 207 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Kamaldeep Bhui ◽  
Simone Ullrich ◽  
Constantinos Kallis ◽  
Jeremy W. Coid
Keyword(s):  
Criminal Justice ◽  
Drug Use ◽  
Psychiatric Care ◽  
Care Pathway ◽  
Population Based ◽  
First Episode ◽  
Black African ◽  
Black Caribbean ◽  
African Patients ◽  
First Contact

BackgroundSome patients are at higher risk of contact with criminal justice agencies when experiencing a first episode of psychosis.AimsTo investigate whether violence explains criminal justice pathways (CJPs) for psychosis in general, and ethnic vulnerability to CJPs.MethodTwo-year population-based survey of people presenting with a first-episode of psychosis. A total of 481 patients provided information on pathways to psychiatric care. The main outcome was a CJP at first contact compared with other services on the care pathway.ResultsCJPs were more common if there was violence at first presentation (odds ratio (OR) = 4.23, 95% CI 2.74–6.54, P<0.001), drug use in the previous year (OR = 2.28, 95% CI 1.50–3.48, P<0.001) and for high psychopathy scores (OR = 2.54, 95% CI 1.43–4.53, P = 0.002). Compared with White British, CJPs were more common among Black Caribbean (OR = 2.97, 95% CI 1.54–5.72, P<0.001) and Black African patients (OR = 1.95, 95% CI 1.02–3.72, P = 0.01). Violence mediated 30.2% of the association for Black Caribbeans, but was not a mediator for Black African patients. These findings were sustained after adjustment for age, marital status, gender and employment.ConclusionsCJPs were more common in violent presentations, for greater psychopathy levels and drug use. Violence presentations did not fully explain ethnic vulnerability to CJPs.

scholarly journals Pathways to care and ethnicity. 2: Source of referral and help-seeking

2005 ◽  
Vol 186 (4) ◽  
pp. 290-296 ◽  
Author(s):  
Craig Morgan ◽  
Rosemarie Mallett ◽  
Gerard Hutchinson ◽  
Hemant Bagalkote ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Help Seeking ◽  
Pathways To Care ◽  
First Episode ◽  
Criminal Justice Agency ◽  
Black African ◽  
African Caribbean ◽  
African Patients ◽  
Pathway To Care

BackgroundPrevious research has found that African–Caribbean and Black African patients are likely to come into contact with mental health services via more negative routes, when compared with White patients. We sought to investigate pathways to mental health care and ethnicity in a sample of patients with a first episode of psychosis drawn from two UK centres.MethodWe included all White British, other White, African–Caribbean and Black African patients with a first episode of psychosis who made contact with psychiatric services over a 2-year period and were living in defined areas. Clinical, socio-demographic and pathways to care data were collected from patients, relatives and case notes.ResultsCompared with White British patients, general practitioner referral was less frequent for both African–Caribbean and Black African patients and referral by a criminal justice agency was more common. With the exception of criminal justice referrals for Black African patients, these findings remained significant after adjusting for potential confounders.ConclusionsThese findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals.

Duration of untreated psychosis and ethnicity in the ÆSOP first-onset psychosis study

2005 ◽  
Vol 36 (2) ◽  
pp. 239-247 ◽  
Author(s):  
CRAIG MORGAN ◽  
PAUL FEARON ◽  
GERARD HUTCHINSON ◽  
KWAME McKENZIE ◽  
JULIA M. LAPPIN ◽  
...  
Keyword(s):  
Mental Illness ◽  
Study Data ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Treatment Delays ◽  
Black African ◽  
Black Patients ◽  
Catchment Areas ◽  
African Patients ◽  
First Contact

Background. There is a common assumption that Black patients with a psychotic mental illness experience longer treatment delays during a first episode. We sought to investigate this issue in a large cohort of patients with a first episode of psychosis.Method. All patients with a first episode of psychosis presenting to secondary mental health services within tightly defined catchment areas in south-east London and Nottingham over a 2-year period were included in the study. Data relating to duration of untreated psychosis (DUP) and clinical and sociodemographic characteristics were collected from patients, relatives and case-notes.Results. There was no evidence that African-Caribbean or Black African patients experienced longer periods of untreated psychosis than White British patients prior to first contact with services. There was evidence that Black African patients experienced shorter periods of untreated psychosis than White British patients.Conclusions. Contrary to what is commonly assumed, our study suggests that Black patients with a psychotic mental illness do not experience longer treatment delays prior to first contact with services than White British patients. This suggests that strategies to reduce treatment delays targeted specifically at Black patients will be of limited value.

scholarly journals Psychoses, ethnicity and socio-economic status

2008 ◽  
Vol 193 (1) ◽  
pp. 18-24 ◽  
Author(s):  
J. B. Kirkbride ◽  
D. Barker ◽  
F. Cowden ◽  
R. Stamps ◽  
M. Yang ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Economic Status ◽  
Population Based ◽  
First Episode ◽  
Prodromal Phase ◽  
Black African ◽  
Affective Psychoses ◽  
Socio Economic Status ◽  
Black Caribbean ◽  
Rate Ratios

BackgroundConsistent observation of raised rates of psychoses among Black and minority ethnic (BME) groups may possibly be explained by their lower socio-economic statusAimsTo test whether risk for psychoses remained elevated in BME populations compared with the White British, after adjustment for age, gender and current socio-economic statusMethodPopulation-based study of first-episode DSM–IV psychotic disorders, in individuals aged 18–64 years, in East London over 2 yearsResultsAll BME groups had elevated rates of a psychotic disorder after adjustment for age, gender and socio-economic status. For schizophrenia, risk was elevated for people of Black Caribbean (incidence rate ratios (IRR)=3.1, 95% CI 2.1–4.5) and Black African (IRR=2.6, 95% CI 1.8–3.8) origin, and for Pakistani (IRR=3.1, 95% CI 1.2–8.1) and Bangladeshi (IRR=2.3, 95% CI 1.1–4.7) women. Mixed White and Black Caribbean (IRR=7.7, 95% CI 3.2–18.8) and White Other (IRR=2.1, 95% CI 1.2–3.8) groups had elevated rates of affective psychoses (and other non-affective psychoses)ConclusionsElevated rates of psychoses in BME groups could not be explained by socio-economic status, even though current socio-economic status may have overestimated the effect of this confounder given potential misclassification as a result of downward social drift in the prodromal phase of psychosis. Our findings extended to all BME groups and psychotic disorders, though heterogeneity remains

Are ethnic differences in pathways to care for psychosis in England reducing?

2019 ◽  
pp. 73-86
Author(s):  
Sherifat Oduola ◽  
Craig Morgan ◽  
Tom K.J. Craig
Keyword(s):  
Family Involvement ◽  
Ethnic Differences ◽  
Psychiatric Care ◽  
Population Based ◽  
First Episode Psychosis ◽  
Pathways To Care ◽  
First Episode ◽  
Black African ◽  
Minority Ethnic Groups ◽  
Episode Psychosis

Studies in the 1990s showed that, compared with the majority populations, people from minority ethnic groups in England were more likely to access psychiatric care via crisis routes. This chapter, and the studies it is based on, explore whether this adverse pattern continues. The authors analysed data from two population-based studies of first-episode psychosis (FEP) carried out 15 years apart. Participants for the studies were 193 FEP patients, aged 18–35 years, presenting to psychiatric care in South London between 1997 and 1999, and 265 FEP patients presenting in 2010–2012. The outcome measure was source of referral during first-episode psychosis. Results of the studies showed that, compared with 15 years ago, ethnic differences were not evident for police or GP involvement. However, ethnic minorities were more likely to access care via accident and emergency departments (Black Caribbean: adj. OR = 48.89; 95% CI = 3.49–684.71; Black African: adj. OR = 7.34; 95% CI = 1.15–46.74). It seems, from these results, that the disparities in pathways to care appear to be narrowing. This may be explained by changing socioeconomic factors and family involvement.

scholarly journals Breast cancer screening uptake among women from different ethnic groups in London: a population-based cohort study

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e005586 ◽  
Author(s):  
Ruth H Jack ◽  
Henrik Møller ◽  
Tony Robson ◽  
Elizabeth A Davies
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Ethnic Groups ◽  
Breast Cancer Screening ◽  
Population Based ◽  
African Women ◽  
Black African ◽  
Screening Uptake ◽  
Black And White ◽  
Black Caribbean

ObjectiveTo use newly available self-assigned ethnicity information to investigate variation in breast cancer screening uptake for women from the 16 specific ethnic groups within the broad Asian, Black and White groups that previous studies report.SettingNational cancer screening programme services within London.Participants655 516 female residents aged 50–69, invited for screening between March 2006 and December 2009. Ethnicity information was available for 475 478 (72.5%). White British women were the largest group (306 689, 46.8%), followed by Indian (34 687, 5.3%), White Other (30 053, 4.6%), Black Caribbean (25 607, 3.9%), White Irish (17 271, 2.6%), Black African (17 071, 2.6%) and Asian Other (10 579, 1.6%).Outcome measuresUptake for women in different ethnic groups aged 50–52 for a first call invitation to the programme, and for women aged 50–69 for a routine recall invitation after a previous mammography. Uptake is reported (1) for London overall, adjusted using logistic regression, for age at invitation, socioeconomic deprivation and geographical screening area, and (2) for individual areas, adjusted for age and deprivation.ResultsWhite British women attended their first call (67%) and routine recall (78%) invitations most often. Indian women were more likely to attend their first (61%) or routine recall (74%) than Bangladeshi women (43% and 61%, respectively), and Black Caribbean women were more likely than Black African women to attend first call (63% vs 49%, respectively) and routine recall (74% vs 64%, respectively). There was less variation between ethnic groups in some screening areas.ConclusionsBreast cancer screening uptake in London varies by specific ethnic group for first and subsequent invitations, with White British women being more likely to attend. The variation in the uptake for women from the same ethnic groups in different geographical areas suggests that collaboration about the successful engagement of services with different communities could improve uptake for all women.

Trouble in the Home, and First Contact with the Criminal Justice System

Caught Up ◽  
2016 ◽  
Author(s):  
Jerry Flores
Keyword(s):  
Criminal Justice ◽  
Drug Use ◽  
Criminal Justice System ◽  
Young Women ◽  
Justice System ◽  
Key Factors ◽  
System P ◽  
Feminist Criminology ◽  
Gender And Crime ◽  
First Contact

In this chapter, I draw on feminist criminology and research on gender and crime to demonstrate how abuse and neglect in the home led the young women in my study to their first contact with the criminal justice system. I pay attention to how home instability is shaped by gendered, racialized, and class-specific challenges. First, I discuss the multiple types of abuse girls experience in the home. This mistreatment led the young women in my study to begin dating at an early age; this new behavior resulted in more abuse at the hands of family members, who viewed their behavior as inappropriate and a violation of “proper” behavior for young Latinas. As this abuse continued, most of the young women in my study began using controlled substances. Soon, they ran away from home. Once on the street, they experienced a new set of challenges, which included finding housing, staying safe, and avoiding physical and sexual abuse. By this point their initial drug use had usually turned into full-blown drug addiction. Drug use and abuse were key factors contributing to first girls’ arrest.

scholarly journals Does depression diagnosis and antidepressant prescribing vary by location? Analysis of ethnic density associations using a large primary-care dataset

2016 ◽  
Vol 46 (6) ◽  
pp. 1321-1329 ◽  
Author(s):  
P. Schofield ◽  
J. Das-Munshi ◽  
R. Mathur ◽  
P. Congdon ◽  
S. Hull
Keyword(s):  
Ethnic Groups ◽  
Population Data ◽  
Ethnic Density ◽  
Depression Diagnosis ◽  
Black African ◽  
Novel Approach ◽  
Minority Ethnic Groups ◽  
Black Caribbean ◽  
Antidepressant Use ◽  
African Patients

BackgroundStudies have linked ethnic differences in depression rates with neighbourhood ethnic density although results have not been conclusive. We looked at this using a novel approach analysing whole population data covering just over one million GP patients in four London boroughs.MethodUsing a dataset of GP records for all patients registered in Lambeth, Hackney, Tower Hamlets and Newham in 2013 we investigated new diagnoses of depression and antidepressant use for: Indian, Pakistani, Bangladeshi, black Caribbean and black African patients. Neighbourhood effects were assessed independently of GP practice using a cross-classified multilevel model.ResultsBlack and minority ethnic groups are up to four times less likely to be newly diagnosed with depression or prescribed antidepressants compared to white British patients. We found an inverse relationship between neighbourhood ethnic density and new depression diagnosis for some groups, where an increase of 10% own-ethnic density was associated with a statistically significant (p < 0.05) reduced odds of depression for Pakistani [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.70–0.93], Indian (OR 0.88, CI 0.81–0.95), African (OR 0.88, CI 0.78–0.99) and Bangladeshi (OR 0.94, CI 0.90–0.99) patients. Black Caribbean patients, however, showed the opposite effect (OR 1.26, CI 1.09–1.46). The results for antidepressant use were very similar although the corresponding effect for black Caribbeans was no longer statistically significant (p = 0.07).ConclusionNew depression diagnosis and antidepressant use was shown to be less likely in areas of higher own-ethnic density for some, but not all, ethnic groups.

scholarly journals Ethnicity and long-term course and outcome of psychotic disorders in a UK sample: The ÆSOP-10 study

2017 ◽  
Vol 211 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Craig Morgan ◽  
Paul Fearon ◽  
Julia Lappin ◽  
Margaret Heslin ◽  
Kim Donoghue ◽  
...  
Keyword(s):  
Service Use ◽  
Psychotic Disorders ◽  
Ethnic Disparities ◽  
First Episode ◽  
Black African ◽  
African Patients ◽  
The Uk ◽  
Multiple Domains

BackgroundThe incidence of psychotic disorders is elevated in some minority ethnic populations. However, we know little about the outcome of psychoses in these populations.AimsTo investigate patterns and determinants of long-term course and outcome of psychoses by ethnic group following a first episode.MethodÆSOP-10 is a 10-year follow-up of an ethnically diverse cohort of 532 individuals with first-episode psychosis identified in the UK. Information was collected, at baseline, on clinical presentation and neurodevelopmental and social factors and, at follow-up, on course and outcome.ResultsThere was evidence that, compared with White British, Black Caribbean patients experienced worse clinical, social and service use outcomes and Black African patients experienced worse social and service use outcomes. There was evidence that baseline social disadvantage contributed to these disparities.ConclusionsThese findings suggest ethnic disparities in the incidence of psychoses extend, for some groups, to worse outcomes in multiple domains.

scholarly journals Perceptions of disadvantage, ethnicity and psychosis

2008 ◽  
Vol 192 (3) ◽  
pp. 185-190 ◽  
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.

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

2005 ◽  
Vol 186 (4) ◽  
pp. 281-289 ◽  
Author(s):  
Craig Morgan ◽  
Rosemarie Mallett ◽  
Gerard Hutchinson ◽  
Hemant Bagalkote ◽  
Kevin Morgan ◽  
...  
Keyword(s):  
Pathways To Care ◽  
First Episode ◽  
Compulsory Admission ◽  
Sampling Frame ◽  
Black African ◽  
Epidemiological Sample ◽  
African Caribbean ◽  
Sample Characteristics ◽  
African Patients ◽  
The Uk

BackgroundMany 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.AimsTo 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.MethodAll patients with a first episode 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 from patients, relatives and case notes.ResultsAfrican–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.ConclusionsThese 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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