Excess use of coercive measures in psychiatry among migrants compared with native Danes

• Published in: Acta psychiatrica Scandinavica Vol. 121; no. 2; pp. 143 - 151
• Main Authors: Norredam, M., Garcia-Lopez, A., Keiding, N., Krasnik, A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-02-2010; Blackwell
• Subjects: Adult; Biological and medical sciences; Coercion; Denmark - epidemiology; Emergency medical care; Female; health service; Hospitalization - statistics & numerical data; Humans; Immigrants; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - rehabilitation; Mental Disorders - therapy; Mental health care; migration; Noncitizens; Patient admissions; Prevalence; Psychiatric Status Rating Scales; Psychiatry; Psychiatry - methods; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; public mental health; Refugees; Registries; Retrospective Studies; Severity of Illness Index; Sex; Transients and Migrants - psychology; Transients and Migrants - statistics & numerical data; Denmark; Mental health; public mental health; coercion; migration; Health service; Psychiatry; Comparative study; Public health
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/j.1600-0447.2009.01418.x

Norredam M, Garcia‐Lopez A, Keiding N, Krasnik A. Excess use of coercive measures in psychiatry among migrants compared with native Danes.
Objective:  To investigate differences in risk of compulsory admission and other coercive measures in psychiatric emergencies among refugees and immigrants compared with that among native Danes.
Method:  A register‐based retrospective cohort design. All refugees (n = 29 174) and immigrants (n = 33 287) who received residence permission in Denmark from 1.1.1993 to 31.12.1999 were included and matched 1 : 4 on age and sex with native Danes. Civil registration numbers were cross‐linked to the Danish Psychiatric Central Register and the Registry of Coercive Measures in Psychiatric Treatment.
Results:  Refugees (RR = 1.82; 95%CI: 1.45; 2.29) and immigrants (RR = 1.14; 95%CI: 0.83; 1.56) experienced higher rates of compulsory admissions than did native Danes. This was most striking for refugee men (RR = 2.00; 95%CI: 1.53; 2.61) and immigrant women (RR = 1.73; 95%CI: 1.45; 2.60). Moreover, refugees and immigrants experienced higher frequencies of other coercive measures during hospitalisation compared with native Danes.
Conclusion:  Coercive measures in psychiatry are more likely to be experienced by migrants than by native Danes.