Doctor's ethnicity also matters

Nilforooshan et al ¹ recently examined the rates and outcome of appeal against detention under the Mental Health Act 1983 for different ethnic groups. They found that Black Caribbean and White Irish groups, although lodging significantly more appeals compared with other ethnic groups (at 63% and 68% respectively compared with 39% White British), were under-represented in the group of patients who successfully had their detention discharged. These findings are revealing, but they would have been more useful if the ethnicity of the tribunal members overseeing the appeal had also been taken into account.

The 2005 Census by the Royal College of Psychiatrists ² reveals the ethnic breakdown of British psychiatrists by grade and highlights the increasing ethnic diversity of psychiatrists in Britain today. Morgan & Beerstecher ³ recently studied general practitioners' practices and found that ethnic minority patients tend to be cared for by ethnic minority doctors. Hence any analysis of the impact of ethnicity on the individual treatment of a patient and of the system of care as a whole would be incomplete and potentially flawed without the inclusion of the ethnicity of the professionals involved. In the decades-old debate on the institutional racism of mental health services, the trend so far has been to assume by default that psychiatrists are ethnically or culturally White British. It is important that future studies take into consideration the evolution of the workforce in terms of ethnicity, but also gender and social class.