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Ethnic disparity in mental health legislation at the point of inpatient entry: pilot review in detained adolescents with developmental disorders
Journal of Forensic Practice ( IF 0.6 ) Pub Date : 2021-08-04 , DOI: 10.1108/jfp-04-2021-0014
Deborah J. Morris 1 , Elanor Lucy Webb 2 , Lowri Foster-Davies 3 , Paul M. Wallang 4 , David Gibbs 5 , Peter D. McAllister 6 , Farshad Shaddel 7
Affiliation  

Purpose

Ethical concerns about the use of the Mental Health Act (MHA) have led to calls for developmental disorders to be removed from the list of mental disorders for which individuals can be detained. In parallel, there are long-standing concerns of ethnic disparity in the application of the MHA. Nonetheless, the impact of the intersections of developmental disorder diagnosis, adolescence and ethnicity on the application of the MHA is unknown. This study aims to explore ethnic differences in MHA sections and the factors accounting for this, in an adolescent inpatient developmental disorder service.

Design/methodology/approach

File reviews were conducted to explore differences in MHA status, as well as demographic, clinical and risk factors that may account for this, between 39 white British and ethnic minority adolescents detained to a specialist inpatient developmental disorder service.

Findings

Consistent with adult literature, adolescents of an ethnic minority were overrepresented in the sample and were significantly more likely to be detained on Part III or “forensic” sections of the MHA than White British counterparts, with five times greater risk. Analyses revealed no significant differences between ethnic minority and white British participants on demographic variables, clinical needs, risk behaviours, risk measures nor application of restrictive practices and safeguarding procedures.

Practical implications

National audits exploring patterns of detention under the MHA across adolescent developmental disorder populations need to include analysis of intersections to ensure that the MHA is used as a means of last resort and in an equitable manner.

Originality/value

To the best of the authors’ knowledge, this paper is the first comprehensive exploration of the impact of ethnicity on detention patterns in ethnic minority and White British populations.



中文翻译:

入院时精神卫生立法中的种族差异:对患有发育障碍的被拘留青少年进行试点审查

目的

对使用《精神健康法》(MHA) 的道德担忧导致要求将发育障碍从可以拘留个人的精神障碍清单中删除。与此同时,在 MHA 的应用中存在长期存在的种族差异问题。尽管如此,发育障碍诊断、青春期和种族的交叉点对 MHA 应用的影响尚不清楚。本研究旨在探讨青少年住院发育障碍服务中 MHA 部分的种族差异以及造成这种差异的因素。

设计/方法/方法

进行了文件审查,以探索被拘留到专科住院发育障碍服务机构的 39 名英国白人和少数民族青少年之间 MHA 状态的差异,以及可能造成这种情况的人口统计学、临床和风险因素。

发现

与成人文献一致,少数族裔青少年在样本中所占比例过高,并且比英国白人同行更有可能被拘留在第三部分或 MHA 的“法医”部分,风险高出五倍。分析显示少数族裔和英国白人参与者在人口统计变量、临床需求、风险行为、风险措施或限制性做法和保护程序的应用方面没有显着差异。

实际影响

探索 MHA 下针对青少年发育障碍人群的拘留模式的国家审计需要包括对交叉点的分析,以确保 MHA 被用作最后的手段并以公平的方式使用。

原创性/价值

据作者所知,本文是第一次全面探讨种族对少数族裔和英国白人的拘留模式的影响。

更新日期:2021-09-21
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