Objectives. To determine whether the emergency psychiatric treatment of patients with psychosis varies with immigrant status and ethnicity. Methods. Data on immigrant and ethnic status of psychotic patients admitted in 1999 were extracted from records of a general hospital in Montreal. Of the 217 subjects, 97 (44.7%) were immigrants, 125 were Euro-Canadian (57.6%),39 were Asian (18.0%), and 27 were Black (12.4%). All Asians and most Blacks (87%) were immigrants. Measures of emergency psychiatric treatment included use of seclusion, restraints, and medication in the emergency department. Multiple regression models examined the relationship of immigrant status and ethnicity to emergency psychiatric treatment controlling for age, gender, patient height and weight, and mode of emergency department admission (coercive versus non-coercive). Results. Immigrant status and Asian ethnicity were not associated with emergency treatment measures. Coercive mode of emergency department admission (i.e. by police or ambulance) predicted use of seclusion (p < .001) and restraints (p < .05), but being Black was independently and positively associated with received dose of emergency antipsychotic (p < .05). Being Black was also positively associated with police or ambulance contact prior to emergency department presentation (p < .01). Conclusion. While some aspects of the emergency treatment of psychosis seem to occur as a consequence of the mode of admission, the administration of antipsychotic medication may be motivated by patient ethnicity. These results point to the need for training of emergency department staff to reduce potential bias in treatment.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33785 |
| Date | January 2002 |
| Creators | Jarvis, G. Eric. |
| Contributors | Kirmayer, Laurence J. (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Psychiatry.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001862660, proquestno: MQ78902, Theses scanned by UMI/ProQuest. |
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