Psychiatric morbidity in people born in Ireland

Background: Irish immigrants are reported to be over-represented in psychiatric admission statistics for England when compared to native whites. This study examines whether this finding is sustained for users of psychiatric services as a whole and explicates the reasons for any differential uptake of mental health care by comparison with community morbidity rates in the same population. Methods: Demographic and clinical data were collected from staff concerning all adults living in a multi-ethnic inner-city health district and using mental health services during a 6-month period. A separate interview-based survey of private household residents in the same area was undertaken to ascertain the prevalence of psychiatric disorder in the community. Results: Psychiatric service use was found to be greater for Irish-born people compared to the remainder of the white population. However, this finding only persisted for alcohol use disorders, the rates for schizophrenic and affective disorders being comparable in the two groups. Access to psychiatric care was also similar both with respect to overall morbidity as well as for affective and alcohol use disorders, levels of service use being attributable to patterns of morbidity in the population rather than nosocomial factors. Conclusions: The excess morbidity for alcohol use disorders reported in people born in Ireland is affirmed and the need for longitudinal and ethnographic research into this important public health issue emphasised. Accepted: 30 July 1999