Patients from BME groups still more likely to be admitted to a mental health hospital

Findings from the fourth annual census of the ethnicity of inpatients in mental health and learning disability services have revealed that some black and minority ethnic groups are three or more times more likely than average to be admitted as inpatients in mental health services.

As a result, the report calls for healthcare providers, local authorities and other statutory agencies to work together to prevent and better manage mental illness in black and minority ethnic groups.

Some black and minority ethnic groups are also more likely to be detained on admission and are more likely to be admitted through the criminal justice system.

The report notes issues such as higher rates of mental illness in some ethnic groups, socio-economic factors, living alone and family and social support, as important factors in the different pathways into care and rates of admission and detention of some black and minority ethnic groups.

The report also calls for organisations that commission and provide mental health and learning disability services to make a “renewed and strenuous” effort to improve access to single-sex wards.

In mental health services, 68% of inpatients did not have access to single sex wards, the same as in 2007. Across learning disability services, 57% of inpatients did not have access to single sex wards.

The Count Me In Census 2008 was a joint initiative by the Healthcare Commission, the Mental Health Act Commission (MHAC) and the National Institute for Mental Health in England (NIHME). It is one of the three key building blocks of the government’s five-year action plan, “Delivering Race Equality in Mental Health Care”.

The census aimed to provide accurate figures on the numbers of inpatients in mental health and learning disability services in England and Wales on one day and to encourage service providers to collect and monitor data on all ethnic groups of patients.

The census was conducted on March 31 this year. It collected information on:
• 31,020 inpatients in 255 of mental health organisations. The proportion of inpatients in independent mental health hospitals increased from 10% in 2005 to 14% in 2008.

• 4,107 inpatients in 129 learning disability organisations across England and Wales. The proportion of inpatients in independent healthcare organisations increased from 20% of the total in 2006 to 27% in 2008. The report emphasises that the collection of accurate data is crucial to monitoring the quality of care patients receive. On this it makes several recommendations to the Department of Health and the Information Centre, including:

• The extension of collection on ethnicity data to primary care

• The submission of patient data be made mandatory for all independent healthcare providers

The report also says that all organisations must continue to improve the recording of the ethnicity of their patients.

Anna Walker, Chief Executive of the Healthcare Commission, said: “The census gives us an important snapshot of mental health and learning disability services on one day. If services are to bring down rates of admission for people from black and ethnic minorities, they must address those factors that can help prevent the illness from becoming so acute that it requires hospitalisation.”

Simon Armson, Chairman of the MHAC, agreed. He said: “The census has once again been a great source of information about the use of the Act for various social groups, and I urge services to consider its findings carefully, both at national and local levels.

“Unless we have information on people who use services, it is impossible to make those services appropriate, or to address urgent questions of pathways into mental health care by some groups within our society.”

Meanwhile Melba Wilson, National DRE Director, said the Census’ findings underscored the importance of the DRE programme continuing to work with commissioners and providers to improve services.

She said: “A key element is to maintain a focus on early intervention in better managing the pathways of care of people from black and minority ethnic communities.

“We are committed to working across sectors, disciplines and agencies to support and encourage change.”