Black psychiatric out-patients appear to be more likely to receive various physical treatments than do British born patients or white immigrants: major tranquillisers and electroconvulsive therapy. Both black patients and white immigrants are more likely to receive intramuscular medication than the British born and have a pattern of out-patient attendance which involves self-referrals, missed appointments and being seen on booked appointments by the most junior members of the therapeutic team. These findings cannot all be adequately interpreted as the result of demographic differences or differing conceptions of mental illness and readiness to seek treatment. They appear to involve either (a) Differences in psychiatric phenomenology which have not been recognised or (b) Stereotyped attitudes of mental health professionals.
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