Ethnic differences in satisfaction with mental health services among representative people with psychosis in south London: PRiSM study 4.

BACKGROUND: Previous studies show that among Black Caribbeans there is a higher prevalence of schizophrenia and higher levels of both voluntary and compulsory admissions. These suggest that Black Caribbean patients may find psychiatric services less appropriate to their needs. The aim of this study was to establish the satisfaction with mental health services of representative psychosis patients in South London, especially in relation to ethnic group. METHOD: A random sample of all cases of psychotic disorder identified in the two sectors was interviewed using the Verona Service Satisfaction Schedule. Questionnaires from 50 Black Caribbean patients and 134 White patients were analysed. RESULTS: Black Caribbean patients, particularly those of second generation born in the UK, were significantly less satisfied with almost every aspect of the services that they received than either older Black Caribbean patients born in the Caribbean or White patients. Using multiple regression analysis it was found that among the younger Black Caribbean patients, unlike the other patients, the number of previous admissions was a significant predictor of dissatisfaction. CONCLUSION: Patients' ratings of satisfaction with mental health services are significantly worse for UK-born Black Caribbean than other patients with psychotic disorder in South London.

Ethnic differences in risk of compulsory psychiatric admission among representative cases of psychosis in London.

OBJECTIVE: To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING: Two defined geographical areas in south London. DESIGN: Annual period prevalent cases of psychosis were identified in 1993 in the study areas from hospital and community data. Standardised criteria were applied to case notes to establish diagnosis and detention under the act. SUBJECTS: 535 patients were identified, of whom 439 fulfilled ICD-10 criteria for psychosis. MAIN OUTCOME MEASURES: Risk of ever having been detained under the Mental Health Act 1983, risk of detention under specific sections of the act during the study year, and risk of contact with forensic services for the different ethnic groups. RESULTS: 439 patients with a psychotic illness were identified. Nearly half of the white patients had been detained under the act compared with 70% and 69% of black Caribbean and black African patients, respectively. Black Caribbean and black African patients were more likely than white patients to have been involuntarily detained (adjusted odds ratio 3.67; 95% confidence interval 2.07 to 6.50 and 2.88; 1.04 to 7.95, respectively). Rates of use of sections 2, 3 and 136 in the study year were higher for black than for white patients, and black patients were more likely than white patients to have been admitted to a psychiatric intensive care facility or prison. CONCLUSION: Independent of psychiatric diagnosis and sociodemographic differences, black African and black Caribbean patients with psychosis in south London were more likely than white patients to have ever been detained under the Mental Health Act 1983.

[Psychosocial variables associated to housing conditions colonized by the vector of Chagas' disease]. / Variables sicosociales que se asocian a la vivienda en condiciones de colonización por el vector de la Enfermedad de Chagas.

The Venezuelan unfinished housing that prevails in the rural areas (palm roof and unfinished walls) is the main factor for the settlement of the Chagas' Disease vector in the country. This research had as principal objective: to explore the social behavior variable that maintain housing in such condition. It was carried out in the Municipality of Tinaquillo, Cojedes State, an endemic zone of this disease. The research was based on a previous study on the same subject. The sample used in that study was revised and improved and the analysis methods were changed. A rural sample was obtained applying the following technics: multivariable analysis, factorial analysis of multiple correspondence and cluster analysis. The results show the existence of four social behavioral types which are associated to the housing condition. The 2/4 group represents a majority group (55.93% of the individuals). In this group the reinitiation of the disease transmission cycle is more feasible due to the existence of a higher number of negative conditions, objective and subjective, associated to the unfinished housing.