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J R Soc Med. 2007 November; 100(11): 489.
PMCID: PMC2099415

Count me in even if I am old!

Shah and McKenzie (JRSM 2007;100:352-3)1 note that the ‘Count Me In’ census2 does not present separate analyses for older patients. The census is a requirement of DRE, providing a one-day snapshot of mental health inpatients. It is not a research database, and has caveats.2

Shah and McKenzie raise an important issue. Admissions for dementia and depression in older black and minority ethnic (BME) patients can be explored readily and effectively through routinely available datasets such as Hospital Episode Statistics (HES), which provide a complete picture of inpatient activity and much supplementary information (e.g. on diagnosis). Ethnicity coding in HES 2005/06 was over 90% complete/valid for mental health specialty patients.

In response to the letter, we analysed admission rates for ages 65 and over from the 2006 census data, and also admissions in HES. Our findings are:

  1. In the 2006 census, age-standardized admission rates for minority ethnic groups at older ages (results available on request) show similar patterns to those reported for all ages. Results for a few minority groups failed to reach significance because of small numbers. Older BME patients in the census are too few in most ethnic groups to support analyses of subgroups within them (e.g. those detained).
  2. Compared with 10,334 inpatients aged 65 and over in the 2006 census, of whom 1098 were BME patients, there were about five times more admissions in HES (51,598 of whom 4850 were BME patients).

We support calls for better information on users of mental health services.3 We've made recommendations for information developments2 that, along with other information initiatives, we are pursuing with the relevant agencies, including the Department of Health. In the interim, researchers may want to draw on the possibilities offered by data sets such as HES, which are widely used for analysing access to and outcomes of inpatient care.4,5


Competing interests None declared.


1. Shah A, McKenzie K. Count me in even if I am old! J R Soc Med 2007;100: 352-3 [PMC free article] [PubMed]
2. Healthcare Commission, Mental Health Act Commission and National Institute for Mental Health in England. Count Me In: results of the 2006 national census of inpatients in mental health and learning disability services in England and Wales. London: Healthcare Commission, 2007. Available at
3. Aspinall PJ. Informing progress towards race equality in mental healthcare: is routine data collection adequate? Adv Psych Treat 2006;12: 141-51
4. Association of Public Health Observatories. Ethnicity and health. UK: AHPO, 2005. Available at
5. Bardsley M, Hamm C, Lowdell C, et al. Developing Health Assessment for Black and Minority Ethnic Groups: Analysing Routine Health Information. London: Health of Londoners Project and NHS Executive, 2000. Available at

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press