Ethnoracial Differences in Coercive Referral and Intervention Among Patients With First-Episode Psychosis

Psychiatr Serv. 2022 Jan 1;73(1):2-8. doi: 10.1176/appi.ps.202000715. Epub 2021 Jul 13.

Abstract

Objective: Using a retrospective sample, the authors sought to determine whether Black patients with first-episode psychosis (FEP) in Canada were at a higher risk for coercive referral and coercive intervention than non-Black patients with FEP.

Methods: Retrospective data from patients referred to an FEP program in 2008-2018 were collected via chart review (N=208). The authors used chi-square and logistic regression analyses to explore the relationships among race-ethnicity, diagnosis of psychosis, and coercive referral and intervention.

Results: Results showed that Black persons of Caribbean or African descent with FEP were significantly more likely to be coercively referred (χ2=9.24, df=2, p=0.010) and coercively treated (χ2=9.21, df=2, p=0.010) than were non-Black individuals with FEP. Age and violent or threatening behavior were predictors of coercive referral. Ethnoracial status, age, and violent or threatening behavior were predictors of coercive intervention.

Conclusions: This study contributes to the dearth of research on Black Canadians and offers insight into factors that may place patients with FEP at risk for coercive treatment. More research is needed to explore the role that ethnoracial status may play in hospital admissions and to uncover the role of racial prejudices in the assessment of danger.

Keywords: Coercion; Involuntary treatment; Psychoses; Racial-ethnic disparities; Retrospective studies; Schizophrenia.

MeSH terms

  • Blacks
  • Canada
  • Humans
  • Psychotic Disorders* / therapy
  • Referral and Consultation
  • Retrospective Studies