Improving care for ethnic minorities: a PHD study on the use of rapid tranquillisation in forensic mental health inpatient settings

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Abstract

Background: Little attention has been devoted to studying mental health inpatient settings where certain ethnic groups are reported to be subjected to more rapid tranquillisation than others (1). Research in forensic settings seems particularly sparce although ethnic minorities make up a substantial proportion of the increasing number of forensic patients. Efforts to reduce/eliminate use of rapid tranquillisation may benefit from a focus on ethnicity and find ways to improve care for this group of patient.

Aim: To advance our understanding of the use of rapid tranquillisation among forensic mental health inpatients from ethnic minority groups and staff decision-making regarding the use of rapid tranquillisation towards such inpatients.

Method: Three phases will be conducted sequentially: 1) a systematic review examining existing knowledge on ethnic disparities concerning use of rapid tranquillisation in mental health inpatient settings; 2) a multiple-case study profiling ethnic minorities receiving rapid tranquillisation in forensic mental health compared with ethnic majorities who are subject to such measures and what characterises staff decision-making in this regard; 3) a think-aloud study examining how patient ethnicity influences staff decision-making in relation to rapid tranquillisation towards forensic mental health inpatients.

Result: Pending.

Discussion: This paper sheds novel light on a largely neglected issue in forensic mental health research, viz. the disproportionate use of rapid tranquillisation towards certain ethnic minorities. Profiling ethnic minorities subjected to rapid tranquilisation and exploring staffs’ decision to apply such measures and any association between these decisions and staff characteristics, the study offers insight into whether and to which extent ethnic disparities occur and if such disparities are maintained by staff as proposed by others (2,3). We thereby conduct groundwork in forensic inpatient health research and prepare the ground for development of interventions and care tools that may reduce or eliminate the use of coercive measures in general and rapid tranquilisation in particular. To date, this has not been developed (4).

References:
1. Beames L, Onwumere J. Risk factors associated with use of coercive practices in adult mental health inpatients: a systematic review. J Psychiatr Ment Health Nurs. 2021. 10.1111/jpm.12757
2. Grey T, Sewell H, Shapiro G, Ashraf F. Mental Health Inequalities Facing U.K. Minority Ethnic Populations. Journal of Psychological Issues in Organizational Culture. 2013;3(S1):146-57. 10.1002/jpoc.21080
3. Norredam M, Garcia-Lopez A, Keiding N, Krasnik A. Excess use of coercive measures in psychiatry among migrants compared with native Danes. Acta Psychiatr Scand. 2010;121(2):143-51. 10.1111/j.1600-0447.2009.01418.x
4. Baker J, Berzins K, Canvin K, Benson I, Kellar I, Wright J, et al. Health Services and Delivery Research. Non-pharmacological interventions to reduce restrictive practices in adult mental health inpatient settings: the COMPARE systematic mapping review. Southampton (UK): NIHR Journals Library; 2021. 10.3310/hsdr09050
Original languageEnglish
Title of host publicationHoratio Congress 2023
Place of PublicationMalta
Publication statusAccepted/In press - 2023

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