Netherlands Institute for Forensic Psychiatry and Psychology, The Netherlands.
Int J Law Psychiatry. 2010 May-Jun;33(3):192-6. doi: 10.1016/j.ijlp.2010.03.010. Epub 2010 Apr 18.
Black and ethnic minorities (BME) are disproportionally represented in western prisons and forensic psychiatric facilities. The authors wished to determine whether patient-related or services-related factors account for this overrepresentation. This study examined the relationship among the assessments of psychological accountability for a crime, treatment recommendations, and ethnicity among persons accused of a crime and suspected of having a mental disorder.
We examined all 21,857 pre-trial psychiatric reports requested by Dutch courts between 2000 and 2006. Ethnicity was classified as Dutch native (n=15,004), Black and minority ethnic (BME) groups (n=6202), and Whites from other western countries (n=638). Accountability assessments and treatment recommendations were compared using chi-square tests and logistic regression models, adjusted for demographic, psychiatric, and judiciary characteristics.
Among BME and Whites from other western countries, accountability for the crimes committed was more often judged to be at the extreme ends of the spectrum, that is, "fully responsible" or "not responsible." Compulsory admission to a psychiatric hospital was more frequently recommended for BME persons (OR: 1.38, 95% CI: 1.16-1.64) and Whites from other western countries (OR: 1.54, 95% CI: 1.05-2.27), but not admission to a penitentiary hospital or use of medication. The compulsory admission findings are largely explained by a higher prevalence of psychotic disorders in BME persons (19.8%) and Whites from other western countries (19.3%) as compared to Dutch natives (9.2%). Outpatient treatment was less often recommended for BME persons (OR: 0.81, 95% CI: 0.76-0.87) and Whites from other western countries (OR: 0.83, 95% CI: 0.70-0.99) than for Dutch natives.
Both patient-related and services-related factors play a role in the increased admission of BME groups and Whites from other western countries to psychiatric hospitals.
黑人和少数族裔（BME）在西方监狱和法医精神病院的比例不成比例。作者希望确定是否是与患者相关或与服务相关的因素导致了这种不成比例的现象。本研究检查了犯罪心理责任评估、治疗建议与犯罪嫌疑人和患有精神障碍的人的种族之间的关系。
我们检查了荷兰法院在 2000 年至 2006 年间要求的 21857 份审前精神病报告。种族被分为荷兰本地人（n=15004）、黑人和少数民族群体（n=6202）以及来自其他西方国家的白人（n=638）。使用卡方检验和逻辑回归模型比较责任评估和治疗建议，调整人口统计学、精神病学和司法特征。
在 BME 和来自其他西方国家的白人中，对所犯罪行的责任判断更常处于极端范围，即“完全负责”或“不负责任”。更频繁地建议 BME 人群（OR：1.38，95%CI：1.16-1.64）和来自其他西方国家的白人（OR：1.54，95%CI：1.05-2.27）强制入院精神病院，但不强制入院监狱或使用药物。强制入院的发现主要归因于 BME 人群（19.8%）和来自其他西方国家的白人（19.3%）中精神障碍的患病率高于荷兰本地人（9.2%）。较少建议 BME 人群（OR：0.81，95%CI：0.76-0.87）和来自其他西方国家的白人（OR：0.83，95%CI：0.70-0.99）接受门诊治疗，而不是荷兰本地人。
患者相关因素和服务相关因素都在增加 BME 群体和来自其他西方国家的白人进入精神病院方面发挥了作用。
