Ethnic variations in detention under the Mental Health Act: a Systematic Review and Meta-Analysis
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Background: Evidence suggests Black, Asian and Minority Ethnic (BAME) groups are at increased risk of involuntary psychiatric care. However, there is no published meta-analysis which brings together both international and UK literature and allows for comparison of the two. This study examines compulsory detention in BAME and migrant groups in the UK and internationally. Methods: A systematic review and meta-analysis of quantitative studies comparing involuntary admission, readmission and length of stay in BAME or migrant groups, compared to majority, or native groups was conducted. Explanations offered for the differences were assessed for the strength of evidence supporting them. Findings: Seventy studies were included. Black Caribbean patients had the highest odds ratio of detention (2·53, CI:2·03-3·16). Black African patients had significantly increased odds (2·27, CI:1·62-3·19), as did, to a lesser extent, South Asian patients (1·33, CI:1·07-1·65). Black Caribbean patients had significantly increased odds of readmission (2·30, CI:1·22-4·34). Migrant groups had increased odds of detention compared to native groups (1·54, CI:1·22-1·95). Evidenced explanations included increased perceived risk of violence and police contact with BAME groups. Interpretation: BAME and migrant groups are disproportionately at risk of psychiatric detention, though there is variation across ethnic groups. Attempts to explain elevated rates of detention in ethnic groups should avoid amalgamation and instead conduct culturally specific, hypothesis driven studies examining the numerous contributors to varying rates of detention.
AuthorsBarnett, P; Mackay, E; Matthews, H; Gate, R; Greenwod, H; Ariyo, K; BHUI, KS; HALVORSRUD, K; Pilling, S; Smith, S
- Centre for Psychiatry