Background: We have previously analysed outcomes for all community treatment orders commenced during a 10-year period in New Zealand. Given Te Tiriti O Waitangi obligations to scrutinise health and consider equity for Māori, we completed this analysis to consider community treatment-order outcomes according to ethnicity.

Methods: Ministry of Health databases provided demographic, service use and medication dispensing data for community treatment-order recipients between 2009 and 2018. As non-Māori on community treatment orders are older, less deprived and less likely to be diagnosed with a Psychotic Disorder, data were categorised according to age (<35/⩾35 years), level of deprivation (New Zealand Dep levels ⩽3, 4-6 and ⩾7) and diagnosis (Psychotic Disorder/non-Psychotic Disorder). The incidences of key outcome measures (admissions, community care, medication dispensing) were calculated for periods on/off community treatment orders for Māori and non-Māori to consider the differential impact of community treatment orders according to ethnicity.

Results: Māori have high rates of community treatment order utilisation and are younger, more likely to be diagnosed with a Psychotic Disorder and spend longer receiving compulsory treatment than non-Māori. Non-Māori are more likely to receive more additional depot antipsychotic medication on-community treatment orders compared with periods off-community treatment order than Māori but other clear patterns of response distinguishing between Māori and non-Māori were not present.

Conclusion: The differences between Māori and non-Māori for community treatment-order utilisation suggest the presence of structural inequity in underlying mental illness distribution and treatment provision. Māori cultural expertise at all levels of healthcare including healthcare planning and delivery is required to make advances and reduce disparity.

Keywords: Compulsory treatment orders; Māori; coercion; community treatment orders.

背景：

我们之前分析了新西兰10年内所有社区治疗令的结局。鉴于《怀唐伊条约》要求审查健康状况并考虑毛利人的公平性，我们完成了这项分析，以根据族裔考虑社区治疗令的结果。

方法：

卫生部数据库提供了2009年至2018年间社区治疗令接收者的人口统计、服务使用和药物分发数据。由于非毛利人在社区治疗令中的年龄较大，社会经济地位较低，并且被诊断为精神病的可能性较小，因此根据年龄（结果：

毛利人的社区治疗令使用率很高，并且年龄较小，被诊断为精神分裂症的可能性较大，在强制性治疗中花费的时间也比非毛利人更长。在社区治疗令期间，与毛利人相比，非毛利人在社区治疗令之外更多地接受了额外的长效抗精神病药物。但没有其他明显的模式可以区分毛利人和非毛利人的反应。

结论：

毛利人与非毛利人之间在社区治疗令使用的差异表明，在潜在的精神疾病分布和治疗提供方面存在结构上的不平等。为了取得进展并减少差距，医疗保健的各个层面都需要毛利文化的专业知识，包括医疗保健规划和实施。

关键词：

强制性治疗令；毛利人；强迫；社区治疗令。