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Cultural aspects of psychiatric clinic utilization a cross-cultural study in Hawaii
Insights
Ethnic background significantly impacts mental health service utilization, with Caucasians over-represented and Japanese under-represented. However, treatment duration and caseloads showed no ethnic disparities once patients entered the system.
Area of Science:
- Psychiatry
- Sociology
- Health Services Research
Background:
- Mental health service utilization often varies across different ethnic groups.
- Understanding these disparities is crucial for equitable healthcare delivery.
Purpose of the Study:
- To analyze the relationship between ethnicity and the utilization of psychiatric outpatient services.
- To investigate ethnic differences in referral sources, symptoms, diagnoses, and treatment duration.
Main Methods:
- Analysis of data from 411 outpatients at a psychiatric clinic in Honolulu, Hawaii.
- Data categorized by ethnic status, demographic variables, welfare status, referral source, symptoms, diagnosis, and treatment duration.
Main Results:
- Clinic utilization showed significant ethnic variation: Caucasians were over-represented, while Japanese and other groups were under-represented.
- Caucasians were more likely to self-refer with anxiety/depression (neurotic diagnoses).
- Japanese and other groups were more frequently referred post-crisis with severe illness (schizophrenic diagnoses), but treatment duration was similar across ethnicities.
Conclusions:
- Ethnicity is a key factor in accessing mental health services.
- Once in treatment, the clinic's response regarding caseloads and treatment duration did not differ by ethnicity.
Abstract:
Data was obtained by ethnic status from 411 outpatients at a psychiatric clinic in Honolulu, Hawaii, and were then analyzed according to demographic variables, welfare status, source of referral, primary compliants or symptoms, diagnosis, and duration of treatment received. Clinic utilization was highly related to ethnicity, with Caucasians highly over-represented in proportion to the population, and other groups, especially Japanese, being greatly under-represented. The Caucasians were more likely to be self-referred, to have subjective symptoms of anxiety and depression, and to receive a neurotic diagnosis. The Japanese, and to some extent all other groups, were more often referred after a crisis or severe mental illness, displayed more socially disruptive symptoms, and had a higher percentage of schizophrenic diagnoses. Ethnicity was thus highly related to utilization of mental health services; however, once entry into the system was made, review of therapist case loads and analysis of duration of treatment revealed no ethnic difference in the clinic's response to patients.