Background. African-Caribbean patients have less desirable routes of entry into the psychiatric services than other ethnic groups in Britain but this may not apply to the first contact with services.Methods. Patients' pathways to care, type of admission or referral and sectioning details were recorded for all first contact patients presenting to south London psychiatric services over a 2-year period. We also conducted a retrospective analysis of data from the Camberwell Register, comparing rates of compulsory admission between ‘Whites’ and ‘African-Caribbeans’ for first and readmissions, over a 20-year period.Results. Our first contact sample comprised 38 White, 38 African-Caribbean and 24 Asian patients with CATEGO defined broad schizophrenia. GP referral was found to be the most common mode of contact and there were no significant differences between the ethnic groups with regard to compulsory admission. Similarly, data from the Camberwell Register showed no significant difference in rates of compulsory admission between first admission White and African-Caribbean patients. However, when all readmissions were examined, African-Caribbeans were more likely to be admitted involuntarily.Conclusions. Our findings suggest that reports of less desirable routes of entry for African-Caribbean patients into the psychiatric service do not apply to their first admission but are likely to develop over time and repeated contact with the services.

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Half of the women in the sample reported at least one act of self-harm in their life and 46% reported making a suicide attempt at some time. Lifetime self-harm was associated with a history of harmful drinking and with being a victim of violence, including physical assault, sexual assault and violence from family and friends. Lifetime suicide attempts were associated with reported violence from family or friends. Current high suicide risk was most common among women on remand. Drug dependence and reported violence from family or friends were both more common amongst white women than black/mixed race women. Self-harm and attempted suicide were generally more common among white women, but black/mixed race women dependent on drugs had the highest proportion of women reporting self-harm. There was tentative support for a three-way association between ethnicity, dependence and self-harm; this raises the possibility that drug dependence may be a predictor of self-harm in the black female prison population.

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