ABSTRACT
The Lagos State Government of Nigeria recently launched its Mental Health Policy and Work Plan aimed at addressing the mental health needs of Lagos, one of the world's fastest-growing megacities, and its nearby communities. This paper discusses the contextual basis of this initiative, its components and the challenges faced so far. It argues that urban centres deserve attention in the current push towards investing in mental health services in low- and middle-income countries.
ABSTRACT
BACKGROUND: High rates of compulsory admission of African/Caribbean patients have been reported. Several factors have been associated with this finding. The roles of some factors related to engagement with services have not been empirically evaluated. AIMS: The aim of this study was to assess the role of engagement factors in compulsory admission of African/Caribbean patients. METHOD: A systematic case-note review was made of the admission process of 100 compulsorily and 100 voluntarily admitted patients; each group containing 50 randomly selected African/Caribbean and White British patients. Information about socio-demographic and engagement factors was collected and the findings compared. RESULTS: Compulsorily admitted African/Caribbean patients had more factors indicative of poor engagement with services than patients in the other groups. Prior to admission, they were less likely to keep their appointments, comply with their medication, contact their GPs and were more likely to present late. Furthermore, they had more history of multiple compulsory admissions. The compulsorily admitted patients, irrespective of ethnicity, also engaged poorly with services. CONCLUSIONS: Poor engagement with primary care and secondary mental health services of African/Caribbean patients appears to be contributing to their high rates of compulsory admission. This aspect of ethnic factors and compulsory admission requires further studies.
