Center for Healthy Communities, School of Medicine, University of California, Riverside (Subica); College of Health, University of Utah, Salt Lake City (Aitaoto); School of Public Policy, University of California, Riverside (Link); Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles (Yamada, Henwood); Borrego Health, Borrego Springs, California (Sullivan).
Psychiatr Serv. 2019 Jul 1;70(7):578-585. doi: 10.1176/appi.ps.201800455. Epub 2019 Apr 17.
This study examined the mental health status, need for services, and unmet need of community-dwelling Native Hawaiian and other Pacific Islanders (NHPI).
Survey data were collected from 223 NHPI adults of Samoan or Marshallese heritage. Surveys were translated into Samoan and Marshallese by using back-translation, with feedback from cultural experts. Severity of depression, anxiety, and alcohol use were measured, as were perceived need for and avoidance of, or delay in, seeking mental health services. Logistic regressions calculated adjusted odds ratios for past-year perceived need for services and avoidance or delay of needed services, controlling for depression, anxiety, and alcohol use.
Participants' screened prevalence of major depression, generalized anxiety disorder, and alcohol use disorder was 21%, 12%, and 22%, respectively. In the past year, 35% and 26% of participants reported needing services and avoiding or delaying needed services, respectively. Urban Samoan and rural Marshallese participants did not differ significantly in measures of depression, anxiety, or alcohol use, even though the groups had significant demographic differences. Female gender and greater familiarity-contact with persons with mental illness were significant predictors of both reporting service need and reporting avoiding or delaying services.
Community-dwelling NHPIs reported a heavy burden of depression, anxiety, and alcohol use, and high perceived need for services, yet low levels of help-seeking. The large unmet need in the sample suggests that a gap may exist between service need and engagement in U.S. NHPI communities that could be targeted with culturally tailored approaches that promote engagement in care.
本研究调查了居住在社区的夏威夷原住民和其他太平洋岛民（NHPI）的心理健康状况、服务需求和未满足的需求。
对 223 名具有萨摩亚或马绍尔群岛血统的 NHPI 成年人进行了调查。调查采用回译的方法翻译成萨摩亚语和马绍尔语，并征求了文化专家的反馈意见。测量了抑郁、焦虑和饮酒的严重程度，以及对心理健康服务的感知需求、回避或延迟寻求服务的情况。使用逻辑回归计算了过去一年中对服务的感知需求以及回避或延迟所需服务的调整后优势比，同时控制了抑郁、焦虑和饮酒的情况。
参与者 screened 出的重度抑郁症、广泛性焦虑症和酒精使用障碍的患病率分别为 21%、12%和 22%。在过去一年中，分别有 35%和 26%的参与者报告需要服务和回避或延迟需要的服务。城市萨摩亚人和农村马绍尔人在抑郁、焦虑或饮酒方面没有显著差异，尽管两组在人口统计学方面存在显著差异。女性性别和与精神疾病患者的熟悉接触程度是报告服务需求和报告回避或延迟服务的两个重要预测因素。
居住在社区的 NHPI 报告了沉重的抑郁、焦虑和饮酒负担，以及对服务的高需求，但寻求帮助的程度较低。样本中大量未满足的需求表明，在美国 NHPI 社区中，服务需求与参与之间可能存在差距，可以通过采用针对特定文化的方法来解决，以促进参与护理。
