Ethnic disparities in the use of seclusion for adult psychiatric inpatients in New Zealand.

AIM

This study aims to investigate disparities in seclusion between Māori and non-Māori non-Pacific (nMnP) adults in mental health inpatient units in New Zealand.

METHOD

This study uses data on 7,239 inpatient psychiatric admissions and 782 seclusion events for nine district health boards (servicing 39% of the New Zealand population) for the period 1 July 2008 to 30 June 2010, from a New Zealand Ministry of Health dataset (PRIMHD). We calculate the age-standardised rates of seclusion per monthly inpatient admissions. Regression modelling of seclusion event rate ratios for Māori compared to nMnP adjusted for age, gender, socioeconomic deprivation (NZDep2006), legal status, referral pathway and diagnosis.

RESULTS

Māori psychiatric inpatients are 39% more likely to experience a seclusion episode than nMnP adults in New Zealand. Important contributors to the disparity in seclusion rates between Māori and nMnP were age and legal status on admission. Adjustment for a range of demographic and admission variables accounted for part of the measured disparity between Māori and nMnP (RR 1.33, fully adjusted).

CONCLUSIONS

To reduce seclusion use for Māori, community mental health services responsive to Māori needs are required to prevent the need for inpatient admission, and reduce the acuity of illness where admission is required.