Ethnic variations in psychotic disorders in the criminal justice system: A systematic review

• We compared BME and non-BME detainees on prevalence rates of psychotic disorders.
• BME detainees had higher prevalence rates of psychotic disorders compared to non-BME detainees.
• This difference was more often found in psychiatric penitentiary units than in regular prison units.
• The phenomenon of elevated rates of psychosis in BME detainees appears to be internationally relevant.

ObjectiveTo explore the relationship between ethnicity, psychotic disorders and criminal behavior by investigating differences in prevalence rates of psychotic disorders between detainees from Black and minority ethnic (BME) groups and non-BME detainees.MethodA systematic review of all empirical studies on the prevalence of psychotic disorders, comparing at least two ethnic groups in a psychiatric penitentiary or regular prison setting. No national or language restrictions were made.ResultsTen out of sixteen medium to high quality studies found higher prevalence rates of psychotic disorders in BME detainees compared to non-BME detainees. The country where a study was executed appeared to be irrelevant to the results. The overrepresentation of BME detainees with psychotic disorders was especially reported on psychiatric penitentiary units and less often on regular prison units.ConclusionsBME detainees show elevated prevalence rates of psychotic disorders compared to non-BME detainees. This phenomenon appears to be internationally relevant.Summations
• The overrepresentation of BME patients is not restricted to certain countries but is of international significance.
• Future research needs to focus on why BME patients with psychotic disorders tend to be overrepresented in the criminal justice system and how it can be achieved to get BME patients into regular mental health care instead.Considerations
• Only a small number of studies included in this review sufficiently controlled for confounding factors. Yet, in cultural research it is essential to take confounding factors into account. More high quality research is needed.