Life events, ethnicity and perceptions of discrimination in patients with severe mental illness

Background: Whilst it is commonly believed that black and ethnic minority ( B&EM) people living in the UK experience social disadvantage compared with the white British (WB) population no study has specifically addressed this issue in patients with severe mental illness. We sought to test the hypothe sis that B&EM patients experience more negative life events than their WE c ounterparts, and to examine the extent to which they attribute these events to discrimination. Method: Thirty-four WE, 78 African Caribbean (AC) and 3 5 other ethnic minority patients with psychotic illnesses, defined using Re search Diagnostic Criteria, were asked to complete a Racial Life Event Ques tionnaire examining life events and perceptions of discrimination at baseli ne and 12 and 24 months later. Results: African Caribbean patients experien ced more 'Financial' life events across the study period, otherwise there w ere no significant differences between patient groups in number of life eve nts experienced. The B&EM group collectively (n = 113), however, were signi ficantly more likely than the WE group (n = 34) to attribute 'Assault'. and 'Legal' life events to discrimination. The AC patient group were significa ntly more likely than the other two ethnic groups to attribute the 'Financi al' and 'Health' life events they experienced to discrimination. The B&EM g roup was also significantly more likely, and particularly the AC patient gr oup, to report that members of their own ethnic group are adversely affecte d by discrimination. Further analyses showed skin colour rather than ethnic ity or nationality to be the major contributing factor to perception of dis crimination; thus, the Irish (n = 11) had similar scores to the WB while Af ricans (n = 16) scored like the ACs. Conclusion: Our study shows that B&EM patients do not experience significantly more life events than WE patients; however, their perception of these events is clearly different, and signif icantly more often attributed to racism. It is reasonable to suppose that p atients may be disinclined to utilise services they believe to be prejudice d against them on the basis of their skin colour, and service providers nee d to be aware of this in order to create health care services that B&EM pat ients feel confident to use.