Survey of patients from an inner-London health authority in medium secure psychiatric care

Abstract

Background: Underprovision by the National Health Service (NHS) has led to an increase in medium secure psychiatric beds managed by the independent sector. Black people are overrepresented in medium secure care. Aims: To describe those people from an inner-London health authority occupying all forms of medium secure provision. To compare those in NHS provision with those in the independent sector, and Black patients with White patients. Method: A census of those in medium secure care in August 1997. Results: The 90 patients in independent sector units were similar to the 93 patients in NHS units except that they were more likely to have been referred from general psychiatric services (48% v. 19%) and less likely to have been referred from the criminal justice system or a high-security hospital (37% v. 63%). There were few differences between Black and White patients. Conclusions: The NHS meets only part of the need for medium secure care of the population of this London health authority. This comparison of the characteristics of Black and White patients does not help to explain why Black people are overrepresented in medium secure settings. Declaration of interest: None. This work was funded by Lambeth, Southwark and Lewisham Health Authority.