Unmet needs and antisocial personality disorder among Black African and Caribbean service users with severe mental illness

Abstract

Purpose

The main objective of the study is to investigate unmet needs of Black African and Caribbean Heritage (BAH) patients with and without a concurrent diagnosis of antisocial personality disorder (ASPD).

Design/methodology/approach

A total of 79 participants were recruited from ten psychiatric inpatient wards across two hospital sites in South London. Personality disorder was assessed using the SCID‐II for DSM‐IV, the prevalence of unmet needs was assessed by The Camberwell Assessment of Need Short Assessment Schedule and substance misuse problems measured using well validated drug and alcohol use disorder identification tools.

Findings

The presence of a concurrent ASPD was independently associated with a greater number of unmet needs. ASPD was associated with lower qualifications and a greater risk of homelessness and substance misuse. Unmet need was associated with lower qualifications and substance misuse. In a stepwise linear regression model alcohol dependence and drug misuse were the most significant predictors of unmet need.

Research limitations/implications

Further research is required to identify the reasons why these needs are not being met and establish reasons for these patients' high‐dropout rates from treatment.

Practical implications

The present findings suggest BAH psychiatric inpatients with ASPD are at greater risk of alcohol dependence and drug misuse and report a greater number of unmet needs thus requiring a greater volume of services; however, current services are not meeting these needs. Mental health teams should ensure thorough needs assessment procedures are incorporated into general psychiatric service practice ensuring effective treatment packages are tailored to these patients needs.

Originality/value

The research identifies a previously under‐researched sub‐group of psychiatric inpatients with a high proportion of unmet health and social needs and suggests further research to develop service improvements supporting their management.

Citation

Gwaspari, M., Hochhauser, S. and Bruce, M. (2011), "Unmet needs and antisocial personality disorder among Black African and Caribbean service users with severe mental illness", Ethnicity and Inequalities in Health and Social Care, Vol. 4 No. 1, pp. 38-48. https://doi.org/10.1108/17570981111189579