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Pathways to Care for Patients with a First Episode of Psychosis

A Comparison of Ethnic Groups

Published online by Cambridge University Press:  02 January 2018

Eleanor Cole ,
Gerard Leavey ,
Michael King ,
Eric Johnson-Sabine  and
Amanda Hoar
Eleanor Cole*
Affiliation:
University Department of Psychiatry, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3
Gerard Leavey
Affiliation:
University Department of Psychiatry, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3
Michael King
Affiliation:
University Department of Psychiatry, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3
Eric Johnson-Sabine
Affiliation:
University Department of Psychiatry, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3
Amanda Hoar
Affiliation:
Department of Psychiatry, St Ann's Hospital, St Ann's Road, London N15
*
Dr Cole, St Ann's Hospital, St Ann's Road, London N15 3TH
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Abstract

Background

It is reported that patients from ethnic minority groups, in particular Afro-Caribbeans, are more likely to enter less desirable pathways to psychiatric care. We aimed to determine whether ethnicity significantly affected time to presentation, type of first contact, rates of compulsory admission and police and primary care involvement, in patients with their first episode of psychosis.

Method

As part of a prospective epidemiological study, patients and their carers were interviewed using a semi-structured questionnaire to trace the various persons and agencies seen en route to their first contact with psychiatric services.

Results

While compulsory admission was more likely for Black patients, the excess was less striking than in previous studies. Black patients were no more likely than other patients to have police involvement. The most important factors in avoiding an adverse pathway were having a supportive family member or friend and the presence of a general practitioner to assist in gaining access to psychiatric services.

Conclusions

The routes to psychiatric services for first onset patients are different to those for chronic patients. Variables associated with social support were more important than ethnicity in determining pathways to care. Police involvement and compulsory admissions were strongly associated with the absence of GP involvement and the absence of help-seeking by a friend or relative. It may be that ethnicity becomes an important variable after the patient has come into contact with psychiatric services.

Type
Papers
Information
The British Journal of Psychiatry , Volume 167 , Issue 6 , December 1995 , pp. 770 - 776
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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