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BACKGROUND: Individual variables and area-level variables have been identified as explaining much of the variance in rates of compulsory in-patient treatment. AIMS: To describe rates of voluntary and compulsory psychiatric in-patient treatment in rural and urban settings in England, and to explore the associations with age, ethnicity and deprivation. METHOD: Secondary analysis of 2010/11 data from the Mental Health Minimum Dataset. RESULTS: Areas with higher levels of deprivation had increased rates of in-patient treatment. Areas with high proportions of adults aged 20-39 years had the highest rates of compulsory in-patient treatment as well as the lowest rates of voluntary in-patient treatment. Urban settings had higher rates of compulsory in-patient treatment and ethnic density was associated with compulsory treatment in these areas. After adjusting for age, deprivation and urban/rural setting, the association between ethnicity and compulsory treatment was not statistically significant. CONCLUSIONS: Age structure of the adult population and ethnic density along with higher levels of deprivation can account for the markedly higher rates of compulsory in-patient treatment in urban areas.

Original publication




Journal article


Br J Psychiatry

Publication Date





157 - 161


Adolescent, Adult, Aged, Aged, 80 and over, Commitment of Mentally Ill, England, Female, Humans, Inpatients, London, Male, Mental Disorders, Middle Aged, Rural Population, Socioeconomic Factors, Urban Population, Young Adult