Editorial is unduly provocative

doi:10.1136/bmj.39176.421435.3A

BMJ 2007;334:761 (14 April), doi:10.1136/bmj.39176.421435.3A

Letters

Institutional racism

Editorial is unduly provocative

The first 150 words of the full text of this article appear below.

As black psychiatrists working in the NHS, we find McKenzieand Bhui's editorial unhelpful and unduly provocative.¹ Forexample, although it is possible that racism has a role in increasingdetention rates among black patients, the editorial ignoresother well established and, in our view, more important factors.

In our combined clinical experience, which includes acute adult,forensic, and child and adolescent psychiatry, and many MentalHealth Act assessments, one of the main reasons for increaseddetention rates for black patients is an inadequate communitysupport network. Supportive intermediaries (such as family members)can increase treatment adherence, detect early relapse signs,and enable early non-coercive intervention.² In our experience,compared to other ethnic minorities, the relative inadequaciesof support networks predispose black patients to adverse carepathways resulting in crisis and police intervention and disproportionateuse of the Mental Health Act. This experience is supported bythe AESOP study, which . . . [Full text of this article]

Cornelius Ani, specialist registrar in child and adolescent psychiatry¹, Obeagaeli Ani, locum consultant child and adolescent psychiatrist²

¹ Academic Unit of Child and Adolescent Psychiatry, Imperial College, London W2 1PG, ² Hertfordshire Partnership NHS Trust, Elstree Way Clinic, Borehamwood WD6 1JT

c.ani@imperial.ac.uk