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RESEARCH WEEKLY: May Research Roundup, AAPI Heritage Month
By Shanti Silver
(May 31, 2023) Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.
This month’s roundup is in honor of Asian American and Pacific Islander Heritage Month and highlights the experiences of AAPI people whose lives are impacted by severe mental illness.
Datapoint of the month
6.3% of Native Hawaiians and other Pacific Islanders have a serious mental illness
According to data from the Substance Abuse and Mental Health Administration’s 2021 National Survey of Drug Use and Health, serious mental illness was more common among people who identified as Native Hawaiian or Other Pacific Islander (6.3%) than in the general population (5.5%). The prevalence of co-morbid substance use disorders were also higher, with 4.1% of people who identified as Native Hawaiian or Other Pacific Islander having both a serious mental illness and a substance use disorder, compared to 2.5% of Americans overall.
Substance Abuse and Mental Health Administration. (December 2022). Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health.
Research of the month
Longer hospital stays for Asian Americans and Pacific Islanders
A recent study used data from more than 1,000,000 patients to examine whether the average length of psychiatric inpatient hospital stays for people with severe mental illness differed between racial groups. In this study, the average length of an inpatient hospitalization episode was six days for people with severe mental illness overall. Black and white patients with severe mental illness also had an average length of stay of six days, while Hispanic and Native American patients had an average length of stay of seven days. In contrast, the average length of stay for Asian Americans and Pacific Islanders was nine days.
While all racial minority groups had a longer length of stay than white patients, this disparity was greatest for AAPI patients. Studies have found that people from racial minority groups are more likely to delay mental health treatments or be unable to access timely, appropriate care for their mental health. The authors suggest that this delay in care leads to people having more severe symptoms at the time of admission, leading to longer stays. For Asian Americans in particular, the authors note that high levels of stigma toward mental health treatment may mean that communities and families discourage people with severe mental illness from seeking professional care. The authors note that interventions that include both cultural sensitivity and financial assistance may be necessary to improve mental health equity across racial groups.
Adepoju, O. E., et al. (June 2022). Hospital Length of Stay in Patients with and without Serious and Persistent Mental Illness: Evidence of Racial and Ethnic Differences. Healthcare.
Shortage of research on Asian American family caregivers
Supporting the mental wellbeing of all family caregivers of people with severe mental illness is very important. Helping a caregiver to manage their own mental health can also help people with severe mental illness, as the wellbeing of a family caregiver can be an important factor in the recovery of a person with severe mental illness. However, a recent review of the literature found that only three published, quantitative studies have examined mental health outcomes for Asian American caregivers of people with severe mental illness.
While few, these studies did reveal some differences between the needs of Asian American and European American caregivers. For example, Chinese American caregivers reported experiencing more stigma and more structural barriers to accessing care than European American caregivers, even when caregiving burden, self-care, social support, mental health, and the severity of their family member’s symptoms were the same between these two groups. Additionally, while social support was a key predictor of better mental health for European American caregivers, self-care practices and lower caregiving burden were predictors of better mental health for Chinese Americans. Asian American caregivers also had overall high levels of positive attitudes, which may be attributed to cultural acceptance of family roles such as caregiving.
The authors note that increased understanding of these and other cultural differences could help to improve the quality of mental health services for Asian American caregivers. However, most participants in these three studies were Chinese American, so the results cannot be generalized to other Asian American populations. Accordingly, more research is still needed to understand how best to support Asian American caregivers of people with severe mental illness.
Li Verdugo, J., Oh, H. Y., & Jang, Y. (March 2023). Mental health of Asian American caregivers of family members with severe mental illness. Psychiatric services.
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