Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review

Purpose: Previous reviews suggest minoritised ethnic patients face inequalities in aspects of inpatient care including involuntary admission and forced medication. This rapid review aimed to identify ethnic disparities in acute adult mental health care and explore to what extent these provide eviden...

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Main Authors: Phuong Hua, Sarah-Jane Fenton, Mark Freestone, Kamaldeep Bhui, Sania Shakoor
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:SSM - Mental Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666560325000908
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author Phuong Hua
Sarah-Jane Fenton
Mark Freestone
Kamaldeep Bhui
Sania Shakoor
author_facet Phuong Hua
Sarah-Jane Fenton
Mark Freestone
Kamaldeep Bhui
Sania Shakoor
author_sort Phuong Hua
collection DOAJ
description Purpose: Previous reviews suggest minoritised ethnic patients face inequalities in aspects of inpatient care including involuntary admission and forced medication. This rapid review aimed to identify ethnic disparities in acute adult mental health care and explore to what extent these provide evidence of institutional racism, as defined by the Macpherson report. Methods: Ovid MEDLINE, Cochrane Library, Ovid PsycINFO, Web of Science and Ovid EMBASE were searched for studies published from January 2018 to August 2024. Quality of evidence was assessed using the Joanna Briggs Critical Appraisal Tools. A synthesis of the studies was performed. Results: Quantitative studies (n = 34) revealed ethnic disparities in involuntary admission, psychiatric diagnoses, forced medication, physical restraint, seclusion, length of stay and access to appropriate services/facilities. Qualitative data (n = 2) revealed experiences of disempowerment, confusion and loss of autonomy. Collectively these findings mapped onto components identified as underlying institutional racism as defined by the Macpherson report. Conclusion: Our current evidence can be used to understand the genesis and perpetuation of insitutional racism in health care settings. This will enable us to better target intervention or change management to address issues where they arise. Further research and analyses are needed however, in order to verify whether ethnic disparities in inpatient services and treatment reflect or are themselves exacerbated or contributed to by institutional racism.
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spelling doaj-art-385dee54a2004adab50af266249644d92025-08-20T03:29:32ZengElsevierSSM - Mental Health2666-56032025-12-01810047810.1016/j.ssmmh.2025.100478Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid reviewPhuong Hua0Sarah-Jane Fenton1Mark Freestone2Kamaldeep Bhui3Sania Shakoor4Bristol Medical School, University of Bristol, Bristol, BS8 2PN, United Kingdom; Corresponding author.School of Social Policy, University of Birmingham, B15 2SQ, United KingdomCentre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Queen Mary, University of London, E1 2AB, United KingdomDepartment of Psychiatry and Nuffield Department of Primary Care Health Sciences, University of Oxford, Wadham College, University of Oxford. Warneford Hospital, OX3 7JX United Kingdom; East London and Oxford Health NHS Foundation Trusts. WPA Collaborating Centre, Oxford, United KingdomCentre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Queen Mary, University of London, E1 2AB, United Kingdom; Corresponding author.Purpose: Previous reviews suggest minoritised ethnic patients face inequalities in aspects of inpatient care including involuntary admission and forced medication. This rapid review aimed to identify ethnic disparities in acute adult mental health care and explore to what extent these provide evidence of institutional racism, as defined by the Macpherson report. Methods: Ovid MEDLINE, Cochrane Library, Ovid PsycINFO, Web of Science and Ovid EMBASE were searched for studies published from January 2018 to August 2024. Quality of evidence was assessed using the Joanna Briggs Critical Appraisal Tools. A synthesis of the studies was performed. Results: Quantitative studies (n = 34) revealed ethnic disparities in involuntary admission, psychiatric diagnoses, forced medication, physical restraint, seclusion, length of stay and access to appropriate services/facilities. Qualitative data (n = 2) revealed experiences of disempowerment, confusion and loss of autonomy. Collectively these findings mapped onto components identified as underlying institutional racism as defined by the Macpherson report. Conclusion: Our current evidence can be used to understand the genesis and perpetuation of insitutional racism in health care settings. This will enable us to better target intervention or change management to address issues where they arise. Further research and analyses are needed however, in order to verify whether ethnic disparities in inpatient services and treatment reflect or are themselves exacerbated or contributed to by institutional racism.http://www.sciencedirect.com/science/article/pii/S2666560325000908Ethnic disparitiesInstitutional racismInpatientMental healthEthnic minoritiesReview
spellingShingle Phuong Hua
Sarah-Jane Fenton
Mark Freestone
Kamaldeep Bhui
Sania Shakoor
Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
SSM - Mental Health
Ethnic disparities
Institutional racism
Inpatient
Mental health
Ethnic minorities
Review
title Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
title_full Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
title_fullStr Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
title_full_unstemmed Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
title_short Ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards: A rapid review
title_sort ethnic disparities as potential indicators of institutional racism in inpatient care within acute mental health wards a rapid review
topic Ethnic disparities
Institutional racism
Inpatient
Mental health
Ethnic minorities
Review
url http://www.sciencedirect.com/science/article/pii/S2666560325000908
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AT kamaldeepbhui ethnicdisparitiesaspotentialindicatorsofinstitutionalracismininpatientcarewithinacutementalhealthwardsarapidreview
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