Psychiatric Morbidity of West Indian Immigrants in an Urban Group Practice

Abstract

This paper reports on a 6 month morbidity survey designed to compare illness and consultation patterns of West Indian and English patients attending the same general practice in London. From the author''s data it appears that West Indians used the general practice in much the same way as the English. A greater percentage of West Indians (48.3%) registered with the practice attended during the study than did English patients (41.8%), and they had a higher period prevalence rate of conspicuous psychiatric morbidity as a group (17.4%) than did English patients (12.6%), although the general trend of physical illness was roughly the same. More specifically there were significantly more West Indian men with CPM than English men. There were also proportionately more West Indian women with CPM than English women, and although this difference was not significant it is of interst in view of previous reports that mental illness among West Indian women is twice as common as in English women. The interview study pointed to definite sources of strain in the West Indian community in London associated with a shift from the agricultural and pastoral life of the West Indies to the strenuous demands of a highly industrialized urban society. These observations suggest that more careful study of the West Indian community in London might provide more specific explanations of the differences in psychiatric morbidity. In addition to the limitations on collecting psychiatric data in general practice due to limited time, diagnostic problems, difficulties in case identification, and difficulties in evaluating the effects of personal and social factors on prevalence, a number of obstacles specific to this study were encountered. First, was the general lack of information about West Indian medical customs and their effects on registration and attendance at the general practice. Second, was the problem of identifying West Indians. These problems, as this report suggests, were not insurmountable. That a migratory, immigrant population could be identified, contacted and studied both in the general practice and in the community suggests the feasibility of studying the health and medical habits of other unidentified groups in large metropolitan areas.