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Comparison of elderly suicide rates among migrants in England and Wales with their country of origin
- Authors:
- SHAH Ajit, LINDESAY James, DENNIS Mick
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(3), March 2009, pp.292-299.
- Publisher:
- Wiley
The black and minority ethnic (BME) elderly population size in England and Wales has progressively increased over the last three decades. A study comparing suicide rates among elderly migrants in England and Wales and in their country of origin using the latest available mortality data from the Office of National Statistics and the World Health Organization was conducted. There were wide variations in standardised mortality ratios for elderly suicides among migrants from different countries compared with those born in England and Wales and in their country of origin. There was convergence towards elderly suicide rates for England and Wales in some migrant groups in males in the age-bands 65-74 years and 75 + years, and in females in the age-band 75 + years. However, males aged 75 + years from most migrant groups had higher rates than those born in England and Wales. A more detailed analysis of suicide of older people from migrant groups is required to determine vulnerability and protective influences.
Methods of elderly suicides in England and Wales by country of birth groupings
- Authors:
- DENNIS Michael, SHAH Ajit, LINDESAY James
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(11), November 2009, pp.1311-1313.
- Publisher:
- Wiley
This brief article presents statistics on methods of suicide used by older males and females, using data on suicides and open verdicts for England and Wales obtained from the Office for National Statistics for the period 2001 to 2005. As data concerning ethnicity are not recorded on death certificates, country of birth was used as a proxy. Although this approach only provides mortality data of first generation migrants rather than for entire black and minority ethnic (BME) groups, there is a close match between ethnicity and country of birth for older people. Individual countries of birth were grouped into broader regional country of birth categories, and the number of suicides for each method was calculated by gender for each country of birth grouping. A combined BME group was then calculated for each gender by combining those born outside England and Wales. The results show that hanging, drug overdose and drowning were the commonest methods of suicide in older people in England and Wales in most country of birth groups; in the female Indian subcontinent group the commonest methods were drug overdose, drowning, and burning; methods of suicide in older people were generally similar in the BME population compared to people born in England and Wales.
The ‘Count Me In’ psychiatric in-patient census for 2007 and the elderly: evidence of improvement or cause for concern?
- Author:
- SHAH Ajit
- Journal article citation:
- Psychiatric Bulletin, 33(6), June 2009, pp.201-203.
- Publisher:
- Royal College of Psychiatrists
The recently published Count Me In 2007 census specifically reported age-standardised admission rates for individuals aged over 65 years from different Black and minority ethnic groups. The standardised admission ratio was higher in the White Irish, other White, White and Black Caribbean, other Asian, Black Caribbean, Black African and other Black ethnic groups; and lower in the White British and Chinese ethnic groups. As this census was undertaken on a single day for all psychiatric in-patients, it measured bed occupancy rather than admission rates and so it was actually referring to standardised bed occupancy ratios. Bed occupancy is a function of admission rates and length of stay. This editorial critically explores factors (including those related to institutional racism) that may affect both admission rates and length of stay, and ultimately bed occupancy, of Black and minority ethnic elders.
Meeting the mental health needs of older people from black and minority ethnic communities
- Authors:
- SHAH Ajit, ADELMAN Simon
- Journal article citation:
- Mental Health Today, November 2009, pp.25-29.
- Publisher:
- Pavilion
- Place of publication:
- Hove
The proportion of people from black and minority ethnic (BME) groups over the age of 65 has progressively increased over the last three decades in England and Wales, and now stands at 8.2 per cent. This article describes the inequality in access to mental health care in older people from BME groups and potential ways forward under the sub-headings: scale of the problem; inequality in mental health care; barriers to receiving appropriate care; recognising and tackling suicide risk; policy context; finding a way forward; and beyond psychiatry
The early experience of consultant psychiatrists in application of the Mental Capacity Act: issues for black and minority individuals
- Authors:
- SHAH Ajit, et al
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 2(2), July 2009, pp.4-10.
- Publisher:
- Emerald
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire studies that examined the experience of consultants in old age psychiatry and consultants in other psychiatric specialities in the early implementation of the MCA pertaining to issues relevant to black and minority ethnic (BME) groups. Fifty-two (27%) of the 196 consultants in old age psychiatry and 113 (12%) of the 955 consultants in other psychiatric specialities returned useable questionnaires. Eighty per cent or more of the consultants in old age psychiatry and consultants in other psychiatric specialities gave consideration to religion and culture and ethnicity in the assessment of decision-making capacity (DMC). Almost 50% of the consultants in old age psychiatry reported that half or more of the patients lacking fluency in English or where English was not their first language received an assessment of DMC with the aid of an interpreter and 40% of the consultants in other psychiatric specialities reported that no such patients received an assessment of DMC with the aid of an interpreter. The low rate of using interpreters is of concern. The nature of the consideration and implementation of factors relevant to culture, ethnicity and religion in the application of the MCA and the precise reasons for the low rate of using interpreters in patients lacking fluency in English or English not being their first language require clarification in further studies.