Are immigrants at a disadvantage in psychiatric in-patient care?

Objective: To assess the utilization of psychiatric in-patient care among immigrants, and to compare immigrants and natives with respect to sociodemographic and clinical characteristics. Method: Analysing a sample of 23 377 consecutive referrals to psychiatric hospitals of a catchment area in 1995-2001. Results: Within this sample, 20% were foreign nationals. Rates of psychotic disorders were similar in immigrants and natives. Regarding other diagnoses, sociodemographic and clinical measures, there were significant differences. Most immigrant groups had higher rates of compulsory admission, were more likely to be admitted with lower illness severity and not to be readmitted, and spent significantly shorter time in hospital, compared with Swiss in-patients. Some of these differences were clearly gender-specific. Conclusion: Service utilization and psychiatric treatment decisions are not explained merely by illness-related aspects in immigrants. Social and cultural factors have to be recognized in order to prevent disadvantages in psychiatric care.