Psychiatric morbidity of overseas patients in inner London: A hospital based study

Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described.19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists.65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted.The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365). Total cost of admissions was GBP350, 600 ($577, 490); average individual cost was GBP11, 116 (range GBP200-81, 000).Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation.Major cities in countries with religious, economical, or tourist attractions have experienced an increase in the influx of visitors; some of whom are mentally unwell, or subsequently become ill whilst in a foreign country.？degaard (1932) described the tendency to travel in people with schizophrenia; more recent literature describe "crisis-flight" as a way of finding a geographical solution to internal problems [1], and airports as concrete representation of subjective conflicts related to separation and reunion at times of crisis [2]. Mental health care models of delivery, such as de-institutionalisation, t