Misra Supriya, Weerasinghe Isha, Yang Lawrence H, Gelaye Bizu, Alegría Margarita
Department of Public Health, San Francisco State University, San Francisco, CA, USA.
Center for Law and Social Policy, Washington, DC, USA.
SSM Ment Health. 2025 Jun;7. doi: 10.1016/j.ssmmh.2025.100392. Epub 2025 Jan 12.
Global research indicates inequities in the incidence, severity, and care of psychosis among immigrants, primarily due to structural and social adversities relative to non-immigrants. However, despite having the world's largest immigrant population, the United States (U.S.) has limited research on this phenomenon. This lack of data obscures potential inequities and presents a missed opportunity to target policies and resources for this population. In this critical analytical review, we briefly summarize the evidence of inequities in psychosis among immigrants in other Western high-income countries, discuss the relevance to immigrants in the U.S. context, identify historical context and contemporary obstacles to studying this phenomenon in the U.S., and recommend strategies to improve research about psychosis among immigrants in the U.S. moving forward. Specifically, effective data collection regarding psychosis among immigrants can be achieved via shifting to person- and community-centered perspectives, leveraging existing federal data systems and funding mechanisms, improving data collection through better tools and collaboration, prioritizing inclusive engagement and recruitment, and broadening conceptions of mental experiences outside of psychiatric diagnoses. However, these investments must center on autonomy and self-determination of immigrants, given the documented harms of coercive care, such as forced treatment of individuals who experience psychosis, which is once again on the rise nationally.
全球研究表明,移民群体中精神病的发病率、严重程度及治疗存在不平等现象,主要原因是相对于非移民而言,他们面临着结构和社会方面的不利因素。然而,尽管美国拥有世界上最大的移民人口,但该国对这一现象的研究却很有限。数据的匮乏掩盖了潜在的不平等,也错失了针对这一群体制定政策和分配资源的机会。在这篇批判性分析综述中,我们简要总结了其他西方高收入国家移民中精神病不平等现象的证据,讨论了美国背景下与移民的相关性,指出了美国研究这一现象的历史背景和当代障碍,并提出了推进美国移民精神病研究的策略建议。具体而言,要实现关于移民精神病的有效数据收集,可以通过转向以个人和社区为中心的视角、利用现有的联邦数据系统和资助机制、通过更好的工具和合作改进数据收集、优先进行包容性参与和招募,以及拓宽精神病诊断之外的精神体验概念。然而,鉴于强制治疗的危害已被记录在案,比如对患有精神病的个人进行强制治疗,而这种情况在全国范围内又呈上升趋势,这些投入必须以移民的自主权和自决权为核心。