African-Caribbean men remanded to Brixton Prison. Psychiatric and forensic characteristics and outcome of final court appearance.

BACKGROUND: African-Caribbean men are over-represented in psychiatric and forensic services and in the prison population. A failure of community services to engage mentally ill African-Caribbean men and their presentation through the criminal justice system culminates in a repeated pattern of forensic service and criminal justice system contact. METHOD: We carried out a cross-sectional survey during a one-year period of a sample of potentially mentally ill men remanded to HMP Brixton in south London. Men were interviewed to establish their place of birth, first language, socio-demographic profile, ethnicity, psychiatric diagnosis, levels of alcohol and substance misuse, criminality, violence involved in their index offence, past psychiatric and forensic contacts and outcome of court appearance. RESULTS: Two hundred and seventy-seven men were interviewed. In comparison with White men, African-Caribbean men were more often diagnosed as having schizophrenia and were more often sent to hospital under a mental health act order. African-Caribbean men were remanded in custody despite more stable housing conditions and more favourable indices of lifetime criminality, substance misuse and violence. CONCLUSIONS: Community services, including diversion schemes, should be especially sensitive to African-Caribbean men with schizophrenia who 'fall out of care', who are not diverted back into care and are therefore unnecessarily remanded.

African Caribbean men remanded to Brixton prison: psychiatric and forensic characteristics and outcome of final court appearance

AIMS: This study aims to examine the influence of ethnic origin on the range of diagnoses, past psychiatric and forensic contacts, and outcome of final court appearance in a random sample of men remanded in Brixton prison health care centre for a psychiatric assessment. METHOD: 277 men were randomly sampled from all men to HMP Brixton and referred to prison health care centres for a psychiatric assessment over a one year period. Men were interviewed immediately after remand to establish their socio-demographic profiles, their psychiatric diagnoses, alcohol and substance misuse histories, criminality, seriousness of index offence and violence involved in their index offence, past psychiatric and forensic contacts and outcome after court appearance. CONCLUSIONS: In this sample, a greater percentage of black men who were remanded in custody had a diagnoses of schizophrenia. They were remanded despite more stable housing and fewer criminal convictions than the white group. Custodial remands could be avoided if community services (psychiatric diversion) were especially sensitive to the needs of black men with severe mental illness.(AU)