The demography of nurses and patients on acute psychiatric wards in England

St Bartholomew School of Nursing and Midwifery, City University, London, UK.
Journal of Clinical Nursing (Impact Factor: 1.26). 04/2009; 18(6):884-92. DOI: 10.1111/j.1365-2702.2008.02362.x
Source: PubMed


To describe the ethnic and demographic composition of staff and patients on acute psychiatric wards in England.
A significant proportion of the UK population (7.6%) belong to an ethnic minority and there are concerns that ethnic minority patients are not well served by psychiatry, in particular that they are subject to excessive force and coercion.
Survey of a random sample of psychiatric wards in three regions.
A survey was conducted of staff (n = 1536) and patients (n = 11,128) on 136 acute admission psychiatric wards.
Ethnic minority patients were more likely to be admitted with a diagnosis of schizophrenia, younger, more likely to be admitted for a risk of harm to others and more likely to be legally detained. The association between ethnic minority status and detention remains, even when risk, age, gender and diagnosis are taken into account. Ethnic minority patients come from areas of greater social deprivation and fragmentation. Ethnic concordance between staff and patients varies, but the greatest difference is found in London where the proportion of minority staff is greater than the proportion of minority patients.
There continues to be evidence that ethnic minority patients are subject to an excessive amount of legal coercion in English mental health services. However, the proportion of staff belonging to an ethnic minority is greater than the proportion of patients.
Solutions to the problem of excessive use of legal coercion with ethnic minority patients need to be found. Changes of recruitment strategies are required if concordance is to be achieved.

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    • "A further 407 selected patients refused to participate, with the most frequent concern being the confidentiality of information in the case notes. Demographic characteristics had a good match to a previously collect sample of over 11,000 admissions to acute psychiatric wards in England (Bowers et al. 2008b): proportion male, this sample 53% vs. reference sample 49%; proportion white British 68% vs. 73%; although this sample was older, proportion 35 years and under 37% vs. 55%. The proportion of the sample detained under the mental health act on admission was 40%, as compared to 47% across all psychiatric services reported by a recent census (Care Quality Commission 2010). "
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    • "Some elements of the data do support its representativeness. For example, the demographic data on staff and patients matches very closely that in the larger City- 128 dataset (Bowers et al., 2008c), and the rate of daytime door locking is slightly higher (up from 30% in 2005 during the original study to 42% in 2008 during this survey), commensurate with known trends. "
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