Influence of prior contact with community mental health services on first inpatient psychiatric admission for ethnic minorities: Findings from the NOMIAC study.

IF 2.5 4区 医学 Q2 PSYCHIATRY
Giuseppe Carrà, Francesco Bartoli, Federico Moretti, Oliviero Villa, Paolo Camera, Cristina Crocamo
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引用次数: 0

Abstract

Background: Research has extensively documented inequalities in inpatient psychiatric care provided to people of minoritized ethnic groups. Nonetheless, the role of their previous engagement with community mental health care has been little studied.

Aims: We aimed at exploring whether previous clinical care can influence key domains of subsequent psychiatric inpatient care for people of ethnic minorities.

Methods: We identified patients with a first hospital admission between 2016 and 2022, from a representative, highly diverse, catchment area of Northern Italy, using electronic health data of the NOMIAC study. We aimed at testing the impact of clinical care prior to admission on indicators of poor inpatient care, as identified by a participatory expert panel, that is, compulsory admission, insufficient length of stay, administration of Long-Acting Antipsychotics (LAI) during the last 7 days before discharge. Multiple regression models, predicted and counterfactual proportions and path analyses from generalized structural equations modeling were used to explore the association between belonging to ethnic minorities and these indicators.

Results: Among 1,524 participants, 18% were from minoritized ethnic groups. While these were more likely to experience an involuntary admission, regardless of previous care received, they were offered appropriate length of stay if had previous engagement with community mental health care. Both belonging to ethnic minorities and mental health care prior-to-admission were independently associated with early LAI administration.

Conclusions: Several ethnic inequalities in inpatient care continue despite previous community mental health care provided. Future research should examine how these disparities translate into clinical outcomes. Nonetheless, there is the need to actively promote equity, improving the quality of inpatient care of minoritized ethnic groups.

之前与社区精神健康服务机构的接触对少数族裔首次入住精神病院的影响:NOMIAC 研究的结果。
背景:研究广泛记录了为少数族裔群体提供的精神科住院护理中存在的不平等现象。目的:我们旨在探讨之前的临床护理是否会影响少数族裔患者后续精神科住院护理的关键领域:我们利用 NOMIAC 研究的电子健康数据,从意大利北部一个具有代表性的、高度多样化的集水区中,识别了 2016 年至 2022 年间首次入院的患者。我们的目的是检验入院前的临床护理对参与性专家小组确定的不良住院护理指标的影响,即强制入院、住院时间不足、出院前最后 7 天使用长效抗精神病药物(LAI)。研究人员利用多元回归模型、预测和反事实比例以及广义结构方程模型的路径分析来探讨少数族裔与这些指标之间的关系:在1524名参与者中,18%来自少数民族群体。尽管这些人更有可能经历非自愿入院,但无论之前接受过何种治疗,如果他们之前曾接受过社区精神健康治疗,他们都能获得适当的住院时间。属于少数族裔和入院前接受过精神健康护理都与早期LAI管理有独立关联:结论:尽管以前曾接受过社区精神健康护理,但住院护理中的一些种族不平等现象依然存在。未来的研究应探讨这些差异如何转化为临床结果。尽管如此,仍有必要积极促进公平,提高少数族裔群体的住院护理质量。
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来源期刊
CiteScore
12.30
自引率
1.30%
发文量
120
期刊介绍: The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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