The influence of client's ethnicity on psychotropic medication management in community mental health services

Objectives: The aim of this study was to investigate whether people born in non-English-speaking countries differed from clients born in Australia on quality of medication management, measured by mean neuroleptic dose, method of administration, use of atypical antipsychotics and perceived compliance with medication, and to investigate the influence of matching the client w ith a case manager from the same ethnic background on these measures. Method: information about medication and perceived compliance was provided for 168 clients of five community mental health services in Melbourne. Chlo rpromazine equivalent doses (CPZe) were calculated, and average dose, route of administration, percentage receiving atypical antipsychotics and percei ved compliance with medication were analysed by country of birth and prefer red language. Each analysis was repeated for clients matched to a case mana ger from the same ethno-linguistic background compared to those with 'unmat ched' case managers. Results: While non-English-speaking background (NESB) clients generally did not receive different dose sizes, those born in Vietnam had a lower mean d ose. People born in a non-English-speaking country tended to be more likely than the Australian born to receive a depot injection, although this was n ot quite statistically significant. Twenty-seven percent of clients receive d an atypical neuroleptic; age was a significant factor, with older clients less likely to receive an atypical. There was no difference in receipt of atypicals or perceived compliance by country of birth, language or gender. Matching for a case manager of the same background had no effect except for route of administration, with matched clients less likely to receive depot medication than unmatched. Conclusions: Generally, the ethnic background of clients had little influen ce on the quality of medication management they received from community men tal health services.