TY - JOUR
T1 - Effects of ethnic density on the risk of compulsory psychiatric admission for individuals attending secondary care mental health services: evidence from a large-scale study in England
AU - McBride, Orla
AU - Duncan, Craig
AU - Twigg, Liz
AU - Keown , Patrick
AU - Bhui , Kamaldeep
AU - Scott, Jan
AU - Parsons , Helen
AU - Crepaz-Keay , David
AU - Cyhlarova, Eva
AU - Weich, Scott
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Cambridge University Press.
PY - 2021/5/20
Y1 - 2021/5/20
N2 - Background Black, Asian and minority ethnicity groups may experience better health outcomes when living in areas of high own-group ethnic density-the so-called 'ethnic density' hypothesis. We tested this hypothesis for the treatment outcome of compulsory admission. Methods Data from the 2010-2011 Mental Health Minimum Dataset (N = 1 053 617) was linked to the 2011 Census and 2010 Index of Multiple Deprivation. Own-group ethnic density was calculated by dividing the number of residents per ethnic group for each lower layer super output area (LSOA) in the Census by the LSOA total population. Multilevel modelling estimated the effect of own-group ethnic density on the risk of compulsory admission by ethnic group (White British, White other, Black, Asian and mixed), accounting for patient characteristics (age and gender), area-level deprivation and population density. Results Asian and White British patients experienced a reduced risk of compulsory admission when living in the areas of high own-group ethnic density [odds ratios (OR) 0.97, 95% credible interval (CI) 0.95-0.99 and 0.94, 95% CI 0.93-0.95, respectively], whereas White minority patients were at increased risk when living in neighbourhoods of higher own-group ethnic concentration (OR 1.18, 95% CI 1.11-1.26). Higher levels of own-group ethnic density were associated with an increased risk of compulsory admission for mixed-ethnicity patients, but only when deprivation and population density were excluded from the model. Neighbourhood-level concentration of own-group ethnicity for Black patients did not influence the risk of compulsory admission. Conclusions We found only minimal support for the ethnic density hypothesis for the treatment outcome of compulsory admission to under the Mental Health Act.
AB - Background Black, Asian and minority ethnicity groups may experience better health outcomes when living in areas of high own-group ethnic density-the so-called 'ethnic density' hypothesis. We tested this hypothesis for the treatment outcome of compulsory admission. Methods Data from the 2010-2011 Mental Health Minimum Dataset (N = 1 053 617) was linked to the 2011 Census and 2010 Index of Multiple Deprivation. Own-group ethnic density was calculated by dividing the number of residents per ethnic group for each lower layer super output area (LSOA) in the Census by the LSOA total population. Multilevel modelling estimated the effect of own-group ethnic density on the risk of compulsory admission by ethnic group (White British, White other, Black, Asian and mixed), accounting for patient characteristics (age and gender), area-level deprivation and population density. Results Asian and White British patients experienced a reduced risk of compulsory admission when living in the areas of high own-group ethnic density [odds ratios (OR) 0.97, 95% credible interval (CI) 0.95-0.99 and 0.94, 95% CI 0.93-0.95, respectively], whereas White minority patients were at increased risk when living in neighbourhoods of higher own-group ethnic concentration (OR 1.18, 95% CI 1.11-1.26). Higher levels of own-group ethnic density were associated with an increased risk of compulsory admission for mixed-ethnicity patients, but only when deprivation and population density were excluded from the model. Neighbourhood-level concentration of own-group ethnicity for Black patients did not influence the risk of compulsory admission. Conclusions We found only minimal support for the ethnic density hypothesis for the treatment outcome of compulsory admission to under the Mental Health Act.
KW - compulsory admission
KW - Mental Health Act
KW - ethnicity
KW - ethnic density
KW - deprivation
UR - http://www.scopus.com/inward/record.url?scp=85106471929&partnerID=8YFLogxK
U2 - 10.1017/S0033291721001768
DO - 10.1017/S0033291721001768
M3 - Article
C2 - 34011424
SN - 0033-2917
SP - 1
EP - 10
JO - Psychological Medicine
JF - Psychological Medicine
ER -