Continuity of contact with psychiatric services: immigrant and Australian-born patients

Background: Under-representation of ethnic minority groups in psychiatric s ervices has been widely reported in Western nations. The present study exam ined whether there were differences between immigrant and Australian-born p atients in their maintenance of contact with a statewide psychiatric servic e system. Methods: Groups were selected on the empirical grounds that they are differently represented in this service system. Employing a form of cas e-control design, four groups of patients were compared: those born in Aust ralia, the United Kingdom, Southern Europe, and South East/East Asia respec tively (n = 79 for each). Groups were identically matched on sex, age, diag nosis (either schizophrenia or bipolar illness) and locality of service. Th e groups did not differ as to the timing of their first appearance in the 3 -year period in which their psychiatric contact was examined. Results: Desp ite their different representation in the psychiatric service system, the f our groups did not differ on measures of continuity of contact. Measures in cluded number of contacts with mental health community services, number of admissions to inpatient wards, length of stay in hospital and the longest i nterval between any two successive service contacts. Conclusions: The commo nly reported underrepresentation of immigrant groups in the psychiatric ser vice system does not appear to be due to greater discontinuation of contact with services. If the assumption of equal community prevalence of disorder is made, then the observed under-representation may be due to differential rates of access to (that is, initial contact with) psychiatric services.