Diversity & Equality in Health and Care Open Access

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Abstract

Inpatients from black and minority ethnic backgrounds in mental health services in Wales: a secondary analysis of the Count Me In census, 2005â??2010

Roiyah Saltus, Carmel Downes, Paul Jarvis, Suzanne Duval

Count Me In was an annual census of mental health inpatients that was undertaken in England and Wales from 2005 to 2010. Apart from brief, unpublished commentaries by the Welsh government, the data generated in Wales have received little attention and limited analysis. This paper presents a secondary analysis of the census data, with a focus on mental health inpatients from Black and minority ethnic (BME) backgrounds in Wales. Analyses focused on the number and characteristics of patients (age, gender, ethnicity, language and religion), the distribution of patients across Wales, sources of referral, detention status under the Mental Health Act 1983 on admission, and length of stay from admission to census day. The results revealed that the numbers of BME patients from different ethnic groups fluctuated over the 6 years; it was difficult to identify any distinct pattern. The number and proportion of BME patients admitted to, or being supervised by, inpatient facilities increased year on year from57 (2.7% of all patients) in 2005 to 76 (3.2%) in 2010. The three highest  ethnic-group categories were ‘Other’, ‘Black African’ and ‘Mixed Caribbean.’ Racialised minorities in Wales were over-represented in inpatient mental healthcare, including compulsory detention. A consistently higher proportion of BME people than White people in Wales were referred from the criminal justice system, while a consistently higher proportion of White people than BME people were referred by GPs. Although the results cannot reveal the care pathways followed by particular groups or indicate emerging trends for the BME inpatient population, there are differences between the majority and minority ethnic population groups.Action is required to address this imbalance, and future data collection is necessary to determine whether this action has any impact. In-depth exploration of care pathways remains another clear priority for research and policy.