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NEWS EXTRA: Zosia Kmietowicz Inquiry needed to discover why black people are more likely to be admitted to mental hospitals than white people BMJ 2005; 331: 1360-f [Full text]

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An unfortunately premature publication that is bound to cause more of the trouble that it seeks to prevent

Ikechukwu O. Azuonye   (7 January 2006)

An unfortunately premature publication that is bound to cause more of the trouble that it seeks to prevent 7 January 2006
Ikechukwu O. Azuonye, Consultant Psychiatrist 10 Harley Street, London, W1G 9PF Send response to journal: Re: An unfortunately premature publication that is bound to cause more of the trouble that it seeks to prevent	It is clear that ‘Count Me In’ is based on the assumption that race discrimination plays a significant part in mental health care in the UK, and that this census was intended to provide ‘evidence’ of the racism, institutional or otherwise, of our psychiatric services. The census found clear differences in the profiles of ‘White’ and Black & Minority Ethnic (BME)patients in psychiatric hospitals. I think that the data should not have been published before answers had been identified to at least the following questions: 1. What was the ethnic distribution of the psychiatric inpatients compared to the ethnic distribution of the general population of the UK? 2. Were there any persons admitted to hospital who did not have any symptoms of mental illness? 3. Were Caucasians and BME people presenting with the same or similar symptoms, at about the same degree of severity, offered different forms of treatment? 4. Was there any evidence that patients of one ethnic group were 'sectioned' while patients of a different ethnic group, presenting similarly, were treated informally? 5. Was there evidence that Caucasian persons who committed the same or similar crimes as BME persons whilst under the same psychiatric disability received a different disposal by the Courts? 6. What was the ethnic distribution of psychiatric inpatients with a history of illicit substance use? 7. What criteria were applied to the diagnosis of the psychiatric illnesses of the patients? 8. Was there evidence that Caucasian patients presenting with the same or very similar symptoms were given a different diagnosis from BME patients? 9. What was the ethnic distribution of the clinical psychiatric staff that provided the inpatient care? 10. Was there evidence that Caucasian and BME clinical staff treated patients differently? 11. Was there evidence that Caucasian and BME patients who put up the same or very similar behaviour were treated differently regarding seclusion? 12. Was there evidence that Caucasian and BME patients who behaved in the same way were treated differently regarding Control & Restraint? ‘Count Me In’ leaves the very strong impression that the Government, itself, had now provided incontrovertible evidence that our mental health services were fundamentally and comprehensively racist in their treatment of BME patients. This impression is bound to worsen the discontent of those who say that our psychiatric services are racist, and the alienation of those who would seek psychiatric help but for their fear that they would be maltreated, perhaps even killed, by the clinical staff purely because of the colour of their skin. We need to know, from EVIDENCE, whether our psychiatric services are racist or not. ‘Count Me In’ should be WITHDRAWN, to be published with the explanation of the data that it has collected. Competing interests: None declared