Chart of the week: The over-representation of Black people as restricted patients in secure hospitals

Each week we present analysis of data in chart form to illustrate some key issues and invite discussion. People with severe mental health problems who are in contact with the criminal justice system can be held as restricted patients in hospitals if they have been assessed as needing treatment. Miranda Davies takes a closer look at new data that shows that 16% of restricted patients in hospital are Black or Black British, despite only making up 3% of the general population.

Data story

Published: 27/05/2022

People in contact with the criminal justice system with severe mental health problems can be held as restricted patients in high secure or psychiatric hospitals if they have been assessed as needing hospital treatment.

Even though Black or Black British people make up just 3% of the general population, new data shows that 16% of restricted patients in hospital are Black or Black British, as the chart below shows.

Most restricted patients are transfers from prison, and we know that people from minority ethnic backgrounds are over-represented in the prison population – 13% of people in prison are Black or Black British – but this alone is unlikely to explain the percentage held in secure hospitals. Black or Black British people are more likely to be detained under mental health legislation, despite the Lammy review reporting that prisoners from a minority ethnic background are less likely to have mental health concerns identified on reception to prison than prisoners from a white background.

The same review provides numerous examples of how minority ethnic groups are treated differently across the justice system. This starts at an early age, as young people from ethnic minorities are more likely to be remanded to youth detention than those from a white background. This can also be seen in other areas, from higher stop and search rates for Black people to more negative experiences in prison being reported by people from minority ethnic groups more broadly.

We need to be clear what underpins any differences by ethnicity in terms of people receiving treatment in secure hospitals, and there have been calls to improve data collection. Data showing admissions to secure hospital by ethnicity – such as the number of people sent directly to hospital by the courts or the numbers recalled – would be useful to improve understanding of the relationship between ethnicity, mental health and treatment within the criminal justice system.

Restricted patients, prison population and general population by ethnic group 27/05/2022

Chart

Note:  

Restricted patients’ data and prison population data are available as part of the Ministry of Justice Offender Management Statistics (Prison population data = Prison population: 31 March 2022. Table 1.4, 31st Dec 2021. Restricted Patients in Hospital data = Restricted patients: 2021. New_Table_9, 31st Dec 2021). General population data is for England and Wales (males aged 15+ and females aged 18+) and is drawn from the ETHPOP database, which provides a modelled set of ethnic population projections for UK local areas. Prison population and restricted patients data has a small amount of missing data which is why the percentages do not equal 100.

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