Perception of problems in psychiatric inpatients: denial, race and service usage

Abstract

The importance of the ways in which people with psychiatric problems construe their difficulties is considered in this study. A study of 60 consecutive acute admissions to wards serving an inner city area in London (UK) is reported. The results indicated that 55.8% of the sample did not consider themselves to have psychiatric problems: 15.4% said that they had no problems at all and 40.4% thought they had physical or social problems rather than psychiatric ones. Although more younger people denied that they had problems and none of those who denied having problems sought the help of a general practitioner, there was a significant association between diagnosis and perception of problems, and when this was taken into account these associations disappeared. Of those who denied having any problems, only one person had no police involvement on admission. Significantly more of those who denied problems were compulsorily admitted and there were significant differences in the proportions of whites and African-Caribbeans reporting different types of problems. African-Caribbeans were both more likely to consider that they had no problems at all and to be compulsorily admitted. Although African-Caribbeans were also more likely to be diagnosed as experiencing psychotic disorders, it was their ethnic status rather than their diagnostic category that determined both their status on admission and the way in which they construed their problems. Denial among whites tended to take the form of somatisation or construction of problems in terms of social difficulties.

Mental health services for youths in foster care and disabled youths

“…[44][45][46] There are data showing that minorities and younger children receive fewer mental health services and psychotherapeutic medications, 31,[47][48][49][50][51][52][53] and so it is likely that overrepresentation of minority racial groups and overrepresentation of children 5 years or younger have contributed to the lower use in this Medicaid group. Finally, our data provide potentially important information on racial characteristics and mental health service use among the Medicaid population.…”

Exploring the Complexity of Compliance in Schizophrenia

“…It has been argued that some ethnic minority groups, for example, Afro-Caribbeans, are more likely to be noncompliant (Sellwood & Tarrier, 1994); particular dif culties in internalizing Western psychiatric values may result in high level of noncompliance among some ethnic minority groups (Perkins & Moodley, 1993). In contrast, Tunnicliffe, Harrison, and Standen (1992) investigated aspects of community psychiatric care in an Afro-Caribbean community and found that ethnicity was not a major factor affecting compliance with depot medication.…”

Insight, symptoms and executive functions in schizophrenia

“…Demographic variables such as age and gender, have not yet been found to be related to poor insight (Amador et al, 1993;Cuesta & Peralta, 1994). However, there is some evidence of a cultural influence on levels of insight, with ethnic minorities presenting lower levels of insight and treatment compliance (Goldberg, Green-Paden, Lehman, & Gold, 2001;Johnson & Orrell, 1996;Perkins & Moodley, 1993;Sellwood & Tarrier 1994;White et al, 2000).…”