Disparities in the Prevalence of Psychiatric Illness in Hawaii's Houseless Population: A Retrospective Chart Review

In the State of Hawaii, previous research has suggested that minority groups such as Native Hawaiians and Other Pacific Islanders are disproportionately affected by mental health disorders and have less access to mental health services. The purpose of this study was to determine if similar disparities in the prevalence of psychiatric disorders among different ethnic groups are also present among Hawaii's houseless population. A retrospective chart review of records from one of Oahu's major houseless outreach clinics was performed to gather patient demographics and reported histories of psychiatric diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic sub-groups. Results demonstrated higher rates of certain serious mental illnesses among the houseless; however, several other psychiatric diagnoses were unexpectedly found to be less prevalent than in the general population. Additionally, houseless Pacific Islander groups were unexpectedly found to often have disproportionally lower rates of psychiatric diagnoses despite being identified as high risk by other studies. Overall, our findings may indicate unique ethnic trends in the prevalence of mental health disorders among the houseless in Hawaii or may suggest increased social and/or cultural barriers to diagnosis among certain groups that will require more diligent screening and culturally competent care from providers.