Fordham University, Graduate School of Social Service, 113 West 60th Street, New York, NY 11375, USA.
Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, USA.
Int J Environ Res Public Health. 2019 Apr 11;16(7):1302. doi: 10.3390/ijerph16071302.
This study investigated the prevalence of unmet mental health care needs (UMHCN) and their associated factors among 2344 Asian Americans directly exposed to the World Trade Center (WTC) attack 10-11 years afterwards. Given the pervasive underutilization of mental health services among Asians, their subjective evaluation of unmet needs could provide more nuanced information on disparities of service. We used the WTC Health Registry data and found that 12% of Asian Americans indicated UMHCN: 69% attributing it to attitudinal barriers, 36% to cost barriers, and 29% to access barriers. Among all the factors significantly related to UMHCN in the logistic model, disruption of health insurance in the past year had the largest odds ratio (OR = 2.37, 95% confidence interval: 1.61-3.48), though similar to functional impairment due to mental disorders. Post-9/11 mental health diagnosis, probable mental disorder and ≥14 poor mental health days in the past month were also associated with greater odds of UMHCN, while greater social support was associated with lower odds. Results suggest that continued outreach efforts to provide mental health education to Asian communities to increase knowledge about mental illness and treatment options, reduce stigmatization of mental illness, and offer free mental health services are crucial to address UMHCN.
本研究调查了 2344 名直接接触世贸中心袭击事件 10-11 年后的亚洲裔美国人的心理健康未满足需求(UMHCN)的流行率及其相关因素。鉴于亚洲人对心理健康服务的普遍利用不足,他们对未满足需求的主观评估可以提供关于服务差异的更细致信息。我们使用了 WTC 健康登记数据,发现 12%的亚洲裔美国人表示存在 UMHCN:69%归因于态度障碍,36%归因于费用障碍,29%归因于获取障碍。在逻辑模型中与 UMHCN 显著相关的所有因素中,过去一年中断医疗保险的可能性最大(OR=2.37,95%置信区间:1.61-3.48),尽管与精神障碍导致的功能障碍相似。9/11 后心理健康诊断、可能的精神障碍和过去一个月中≥14 天的精神健康状况不佳也与 UMHCN 的发生几率更高相关,而更多的社会支持则与较低的几率相关。研究结果表明,持续开展外联工作,向亚洲社区提供心理健康教育,增加人们对精神疾病和治疗选择的认识,减少对精神疾病的污名化,并提供免费的心理健康服务,对于解决 UMHCN 至关重要。