Ethnic differences in admission to a regional secure unit

White and Afro-Caribbean patients admitted to a regional secure unit (RSU) were compared on a number of variables. The majority of all patients were previously known to local psychiatric services. Afro-Caribbeans were admitted in numbers greatly in excess of their representation in the local population, and were significantly more likely to be referred from the prison system whilst on remand. In contrast, white patients were more often admitted from National Health Service (NHS) and special hospitals. Significantly more Afro-Caribbeans than whites were socially isolated, had a previous criminal history and had a history of previous compulsory admission. They were also significantly more likely to be diagnosed as schizophrenic and to require transfer whilst on remand in custody for urgent psychiatric treatment. Also a larger number received restriction orders; however, this just failed to reach statistical significance. The possible reasons for these findings were discussed in terms of the over-representation of Afro-Caribbeans in the prison system, the association between psychiatric illness and arrest, and the role of the local psychiatric services.