Risk of Involuntary Admission among First-Generation Ethnic Minority Groups with First-Episode Psychosis: Estimates from Population-Based Health Administrative Data

Poster B6, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Kelly K. Anderson1,2,3, Rebecca Rodrigues1, Arlene MacDougall1,2; 1Department of Epidemiology & Biostatistics, The University of Western Ontario, 2Department of Psychiatry, The University of Western Ontario, 3Institute for Clinical Evaluative Sciences

Background: It is well established in the international literature that ethnic minority groups often have more complex and aversive pathways to care. However, Canadian data on this trend is lacking, particularly regarding involuntary admissions. We sought to examine the risk of involuntary admission among first-generation ethnic minority groups. Methods: Using health administrative data, we constructed a retrospective cohort of first-onset cases of psychotic disorder in Ontario between 2009 and 2016. This cohort was linked to data from Immigration, Citizenship, and Refugee Canada for information on migrant status and country of origin. We followed the cohort for a two-year period after first diagnosis to ascertain the first psychiatric hospitalization event, and compared the risk of having involuntary status for first-generation ethnic minority groups relative to a general population reference group. Results: Of the 6204 psychiatric hospitalizations in our study cohort, 18.9% (n=1172) were attributed to first-generation migrants. After adjustment for socio-demographic, clinical, and service-use factors, migrants from Europe (OR=1.89, 95%CI=1.19-3.00), the Caribbean (OR=1.77, 95%CI=1.05-2.99), and Africa (OR=2.55, 95%CI=1.34-4.86) had higher rates of involuntary admission, compared to the general population. There was also evidence of effect modification by gender, with African males having particularly high rates of involuntary admission (OR=6.63, 95%CI=1.40-31.38). Conclusions: Our findings are consistent with the international literature showing increased rates of involuntary admission among some ethnic minority groups with first-episode psychosis. Interventions aimed at improving pathways to care could be targeted at these groups to reduce disparities in access to care for people with psychotic disorders.

Topic Area: Epidemiology

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