Thursday, March 29, 2012

Architecture and Psychosis

The effect of the built environment (prisons/neighborhood structures) on rates of affective and reactive psychosis.

Is the patient an ultra rapid CYP 2D6 metabolizer?  Why is  accountability more often undiminished and less often diminished in the black and ethnic minority populations?

A black man (citizen) or black man from other part of Europe (non-citizen) or black African man (citizen or non-citizen) is three times more likely to be indicted of a crime; similarly, why is compulsory admission to a psychiatric facility 6% versus 2.6% in the local white population?

What if a patient has a decreased capacity to process certain compulsory medications?  (See: BME populations).  (Also: CYP2D6 allele frequency in Curacao.)

Who assesses the pre-trial reports that might result in compulsory admission to a psychiatric facility?

Singh 2007: British Journal of Psychiatry: BME patients disproportionately detained under the Mental Health Act.

See: The killing of Jonathon Zito by Christopher Koomis on the 24th of March, 2009.  Track: Koomis care history and diagnosis.

Consider: misdiagnosis, discrimination, differences in illness expression as related to higher psychosis rates in BME populations.

"The extremes of the spectrum are increasing." -- The beautiful, extremely young Dutch psychiatrist in an ill-fitting pale yellow linen suit who starts to sweat as he shouts this last thing out, just before his study of the Dutch prison system and an analysis of the psychosis rates of the Dutch native, Turkish, Morroccan, Surinamese, Antillean and other non-western populations gets the biggest take-down of the conference.

(Notebook decompression: World Association of Cultural Psychiatry: Congress (3): London, March 2012)

I left the building to sit on the cemetery steps.  This is the NOVO cemetery, an early immigrant Spanish and Portuguese (Jewish) cemetery in Mile End, surrounded now by the campus buildings of Queen Mary's College:

My mother used to teach art, music and poetry in primary schools almost entirely comprised of non-native children, both in Mile End and Bethnal Green.  She'd wake at 4 a.m. to make the unleavened dough for our evening chapatis, boil the rice, cook the daal and one vegetable dish.  Then, she'd commute on the Metropolitan Line to Liverpool Street, where she'd change to the Central line.