Detention Rates Research Articles

Ethnicity and the Mental Health Act 1983

Black and minority ethnic (BME) patients are disproportionately detained under the Mental Health Act 1983. There has been no systematic exploration of differences within and between ethnic groups, nor of the explanations put forward for this excess. To systematically review detention and ethnicity, with meta-analyses of detention rates for BME groups, and to explore the explanations offered for ethnic differences in detention rates. Literature search and meta-analysis. Explanations offered were categorised, supporting literature was accessed and the strength of the evidence evaluated. In all, 49 studies met inclusion criteria; of these, 19 were included in the meta-analyses. Compared with White patients, Black patients were 3.83 times, BME patients 3.35 times and Asian patients 2.06 times more likely to be detained. The most common explanations related to misdiagnosis and discrimination against BME patients, higher incidence of psychosis and differences in illness expression. Many explanations, including that of racism within mental health services, were not supported by clear evidence. Although BME status predicts psychiatric detention in the UK, most explanations offered for the excess detention of BME patients are largely unsupported.

Academic and Educational Outcomes of Children With ADHD

Attention-deficit/hyperactivity disorder (ADHD) is associated with poor grades, poor reading and math standardized test scores, and increased grade retention. ADHD is also associated with increased use of school-based services, increased rates of detention and expulsion, and ultimately with relatively low rates of high school graduation and postsecondary education. Children in community samples who show symptoms of inattention, hyperactivity, and impulsivity with or without formal diagnoses of ADHD also show poor academic and educational outcomes. Pharmacologic treatment and behavior management are associated with reduction of the core symptoms of ADHD and increased academic productivity, but not with improved standardized test scores or ultimate educational attainment. Future research must use conceptually based outcome measures in prospective, longitudinal, and community-based studies to determine which pharmacologic, behavioral, and educational interventions can improve academic and educational outcomes of children with ADHD.

Ethnicity and detention in the UK: A systematic review and meta-analysis

Background: In the UK, Black and minority ethnic (BME) patients have been reported to be disproportionately detained under the Mental Health Act. Aims: Systematic review of all UK literature on ethnicity and detention with meta-analysis of detention rates for BME patients, to determine range of explanatory hypotheses and examine the evidence for these hypotheses Methods: Electronic data bases searched for all date-based studies (1984-2005). Meta-analyses performed where data available. Explanations offered for any excess categorised and evidence examined. Results: 49 studies identified, 19 included in meta-analyses. Compared with White patients, Blacks were 3.83 times, BME patients 3.35 times and Asians 2.06 times more likely to be detained. Racial stereotyping and discrimination against BME patients was the most often cited explanation (53% studies); followed by alienation and mistrust of psychiatric services (28%); higher rates of psychosis (22%); delay in help seeking (18%); and misdiagnosis/ under recognition of illness (16%). There was no primary evidence provided by any study to confirm any of these explanations, while some papers presented data that contradicted these explanations. Conclusions: BME patients experience higher rates of detention under the MHA than White patients. Available explanations offered for this excess are largely unsupported. Explanations such as ‘institutional racism’ in psychiatry neither accurately account for the excess, nor help find ways of reducing detention rates.

A Reductionist Penal Policy and European Human Rights Standards

Official discourse in many European countries advocates the use of imprisonment as a measure of last resort. This principle is also at the core of several Recommendations of the Council of Europe and a Resolution of the European Parliament. In practice, detention rates in European countries vary greatly, and many countries have witnessed an increase in their prison population. This article argues that the application of deprivation of liberty raises in itself a human rights issue, and considers the support that European human rights instruments give to a reductionist penal policy. It concludes by defending a normative argument in favour of rethinking the principle of proportionality in its application to imprisonment.

Project Confirm

When a foster care youth has been arrested, several child-serving agencies are required to communicate effectively to ensure that a responsible guardian is present to take custody. Exploratory research suggests that, in some cases, judges detain children unnecessarily because their guardians fail to appear. This article presents the results of an evaluation of Project Confirm, a program designed to reduce the unnecessary detention of foster care youth. The evaluation reveals a disparity in pre-adjudication detention rates between foster and nonfoster juveniles with similar characteristics both before and after the introduction of the program. The lack of an average program effect on this disparity is explained by the fact that the disparity decreased for juveniles with less serious records but increased for those with more serious records. Finally, both the disparity in detention prior to the program and the program effect differed according to juveniles’ gender, race, and court county.

Delinquency and Justice

In an attempt to demonstrate the value of case study research on delinquency in American Indian communities, Tribal Court juvenile records from one western American Indian community, 1991 through 1998, were analyzed and interviews conducted with community members. Most arrests of juveniles were for alcohol possession and consumption, conduct offenses and status offenses. The most severe offense was simple assault. Youths were more likely to be detained for underage consumption than youths off reservation. Few bookings (26%) resulted in court hearings and all cases resulted in dismissal, deferred adjudication, or deferred sentencing. Girls had higher rates of arrest and detention than males. Interviews identified alcohol consumption and erosion of the extended family as correlates of delinquency.

Report refutes claims that Scotland’s detention rates outstrip rest of UK

Report refutes claims that Scotland’s detention rates outstrip rest of UK

How Do the Laws of Probability Constrain Legislative and Judicial Efforts to Stop Racial Profiling?

Faced with pending legislation and litigation, numerous jurisdictions have begun programs to monitor a range of traffic stop outcomes, focusing on variation by race or ethnicity. Existing programs, however, ignore the unequal outcomes that motivate opposition to racial profiling. Statistical relationships limit the ability of public policy to equalize the various outcomes, even if officers do not engage in racial profiling to any extent or degree. This article demonstrates relationships among five outcomes that are or should be considered when policy on racial profiling is formulated: search rates, find rates, thoroughness of search, rates of detention of the innocent, and rates of apprehension of the guilty. Once decisions are made as to how to balance desires for equality of each of these outcomes, problems remain that are common to statistical assessments of pattern- or practice-of-discrimination claims.

Poverty, poor services, and compulsory psychiatric admission in England.

Compulsory admission is a central feature of psychiatric systems internationally but the factors determining its use within different legal systems are not understood. Numbers of compulsory psychiatric admissions vary widely between areas in England. We examined the hypothesis that variation in rates of detention is related to social deprivation and also to the functioning of local mental health services. Rates of detention under sections 2 and 3 of the Mental Health Act (1983) in 1998/9 were obtained in 34 mental health sectors in eight Trusts in England. Measures of socio-economic deprivation and measures of service function were used to conduct an ecological analysis. Compulsory admission is associated with measures of deprivation but there is unexplained variation. The range in rates is higher than allowed for by the resource allocation formula. Some indicators of service quality are independently associated with rates of detention. Variation in detention rates and its relation to service function need further explanation if the use of compulsion is to be reduced.

Detention of the mentally ill in Europe--a review.

The frequency of compulsory admission varies widely across Europe. Although there has been some research on a nation-wide level, no work has been done to compare mental health legislation in different countries in relation to detention rates and to patients' perception of hospital detention. Databases and government statistics were searched for regional, national and European data. Legal frameworks were compared and reviewed in relation to patients' and professionals' views. Nearly 20-fold variations in detention rates were found in different parts of Europe. Criteria for detention of the mentally ill are broadly similar when it comes to patients at risk to themselves or others. However different rules apply for involuntary treatment in the interest of the patient's health. Variations in detention rates across Europe appear to be influenced by professionals' ethics and attitudes, sociodemographic variables, the public's preoccupation about risk arising from mental illness and the respective legal framework.

Age, gender and ethnicity of those detained under Part II of the Mental Health Act 1983.

Aggregate returns give limited information about those detained under the Mental Health Act 1983. To use existing data-sets to examine detentions under Part II of the Act. Data from 26 areas, with a combined population of 9.2 million, were combined. Population census data were used to standardise rates of detention by age, gender and ethnicity. The 31 702 detentions are distributed bimodally with peaks at age 25-34 years and at over age 80 years. In the younger age group rates of detention are higher for men. The excess of women in the older group is no longer apparent when rates are standardised for age and gender. Detentions are over six times more likely to be of Black people than of White (450 v. 68 per standardised 100 000 population). The difference in rates of detention between Black and White people is greater than previously thought. The excess of older women detained under Part II of the Act is largely due to the lower life expectancy of men.

Detention under the Mental Health Act: balancing rights, risks and needs for services

Mental health law has to balance considerations of both justice, and health and welfare. In the political climate of the 1990s mental health services have become targeted on those with serious mental illness, to address the objectives of containing risks and limiting service expenditure. This paper identifies that increasing rates of detention under the Mental Health Act through the 1990s in a particular region, disproportionately involve longer-term detentions (under section 3), men, and people with serious mental illnesses. Those detained are likely to experience social difficulties. Changes in legislation are imminent, and the paper concludes that thought should be given to the amount of statutory intervention in the lives of seriously mentally ill people, and to the principle of reciprocity in relation to those coerced for lesser periods. Services should seek to address the issues of social exclusion which are reflected in the circumstances of those detained.

Detention under the Mental Health Act: balancing rights, risks and needs for services

Mental health law has to balance considerations of both justice, and health and welfare. In the political climate of the 1990s mental health services have become targeted on those with serious mental illness, to address the objectives of containing risks and limiting service expenditure. This paper identifies that increasing rates of detention under the Mental Health Act through the 1990s in a particular region, disproportionately involve longer-term detentions (under section 3), men, and people with serious mental illnesses. Those detained are likely to experience social difficulties. Changes in legislation are imminent, and the paper concludes that thought should be given to the amount of statutory intervention in the lives of seriously mentally ill people, and to the principle of reciprocity in relation to those coerced for lesser periods. Services should seek to address the issues of social exclusion which are reflected in the circumstances of those detained.

The safety and quality of open registers and a new approach for classifying risky ships

By examining 20 years data, the paper attempts to outline the safety and quality records of open registers, and to establish a relationship of accidental total loss rate with ship quality factors, e.g., certificate, crew performance and equipment indicated by detention rates. It confirms that loss rate, detention rate and age of ships are highly correlated with each other. It shows that the loss rates and detention rates of open registers are above the world average, but with the exception of Liberia, Marshall Islands and Barbados. A new approach is suggested for assessment of ships safety score.

Investigation, Detention and Release of Ships under the Paris Memorandum of Understanding on Port State Control: A View from Practice

AbstractThe Paris Memorandum of Understanding on Port State Control (MOU) shall eliminate the operation of substandard ships in the ports of Europe. It does not set up additional safety requirements. Instead, it shall help to enforce rules and standards laid down in international agreements ("relevant instruments") on ships regardless of the flag they are flying. The control is carried out by surveyors (Port State Control Officers, PSCOs) appointed by the port state authorities. Ships are selected for control with regard to the typical hazards that certain types of ships pose, and to a "rolling list" of flags with especially high detention rates. If a deficiency is found, the surveyor can impose measures ranging from an instruction to rectify them before departure, or within two weeks, or in the next port of call, to the detention of the ship. The legal basis for the detention must be found in the "relevant instruments" implemented by the domestic law of the port state. The owner or operator of the detained ship has a right of appeal. Appeal, however, does not suspend detention.

The use of compulsory powers by approved social workers in five local authorities: Some trends over two years

This paper represents the second report of an ongoing collaborative project and charts the activities of social workers undertaking their duties within the framework of the 1983 Mental Health Act for two years. Approved Social Workers are involved in a range of activities under the Act, but most commonly they are involved in assessments with a view to compulsory detention. The paper examines rates of assessments and detentions under the Act, and identifies marked increases over the two years 1990 and 1991. More people are detained under Section 3 of the Act in particular, and more detentions occur from informal in-patient status. Comparisons with an earlier national study confirm these trends. People aged over 75 years are analysed separately, and increases are identified in the rates of referral and detention, particularly for those with mental health problems other than dementia. In the second year, more were identified who were living in staffed accommodation, or with relatives. The findings of the stu...

The 1983 Mental Health Act in five local authorities: a study of the practice of approved social workers.

This paper represents the first report of an ongoing collaborative project and charts the activities of social workers undertaking their duties within the framework of the 1983 Mental Health Act in five English Local Authorities for one year. Social workers are involved in a range of duties under the Act, but most commonly they are involved in assessments with a view to compulsory detention. The characteristics of people assessed are examined, and a profile emerges of vulnerable subgroups, typically younger men, older women, and people living in socially impoverished situations. Considerable variation between Authorities is found in terms of numbers of assessments, and in numbers of detentions. Low levels of 'diversion' into alternative care are identified. Comparisons are made with a major national study which took place four years earlier. Higher rates of detention are found on average, but lower rates of use of emergency provision (Section 4). An examination of the organisational context within which Approved Social Workers (ASWs) practice reveals a great deal of variation between authorities in terms of the ongoing experience of assessments available to ASWs. Social workers based in Emergency Duty Teams and Hospital Teams are compared, and a distinctive profile of their work emerges, the hospital-based ASWs being more likely to be assessing 'known' people, often already in hospital, and referred for assessment by consultants. The implications of these findings for the management and deployment of Approved Social Workers are briefly discussed. The emphasis is upon the role of the ASW in terms of balancing the rights and needs of people assessed under the Act.

Reducing Juvenile Detention Rates or Expanding the Official Control Nets: An Evaluation of a Legislative Reform Effort

Reform-oriented laws in the area of juvenile justice, despite their specific intent, generally have negative as well as positive potential. Changes in law designed to reduce the juvenile population under state control are a case in point. Research shows that the effect of such laws often is to increase rather than decrease the number of juveniles subject to official control. When the effect of a law designed to reduce the population of juveniles under state control is to cause that population to increase, it is commonly called “net widening.” The present study examines a recent change in Florida's juvenile detention law that was designed, in part, to reduce overcrowding in the state's secure detention facilities.

Routes to psychiatric inpatient care in an Inner London Borough

A study is reported in which pathways to psychiatric inpatient care were investigated in an Inner London Borough. Data were collected on a series of 52 consecutive admissions of adults to the psychiatric wards serving the area. The most striking feature of the results was the variety of routes taken to inpatient care, combined with a high level of police involvement (23.1% of admissions) and low level of referral from General Practitioners (15.4% of admissions). Significant age differences in routes to care were found: those under 30 years were usually brought to hospital by the police or presented directly to psychiatric emergency services; those over 30 typically came via medical/surgical hospital services, domiciliary psychiatric services or psychiatric outpatients. There were no differences in the routes taken by Afro-Caribbean and white people or by men and women. Higher proportions of Afro-Caribbeans received a diagnosis of schizophrenia, considered themselves to have nothing wrong with them and were compulsorily detained. Higher proportions of whites were diagnosed as depressed and considered themselves to have physical problems rather than psychiatric ones. However, results clearly indicated that it was ethnic status rather than diagnostic category that accounted for the higher rates of compulsory detention of Afro-Caribbean people. The implications of the findings for service development and delivery are considered.

The compulsory detention of Afro‐Caribbeans under the Mental Health Act

Abstract Four interrelated studies are described. These show that not only do more Afro‐Caribbeans than expected enter the psychiatric in‐patient system, but they are more likely to be detained under the Mental Health Act and to receive treatment in secure facilities. At each point in the system the proportion of Afro‐Caribbeans increases, from informal to civil commitment to detention on forensic sections via the courts. The findings apply to both migrant and British‐born Afro‐Caribbeans, and the highest detention rates are found in the second generation. A high total number of admissions and diagnostic differences account for most of the excess Afro‐Caribbeans admitted under civil sections (Part II of the act) but not on the forensic sections (Part III). The possible explanations for these findings are discussed. For Part II, the contribution of misdiagnosis, the effects of socio‐economic disadvantage and the use of the psychiatric services are considered. For Part III, aspects of racial stereotyping an...