Learning Objective #1: Describe the influence of ethnicity on the treatment and care of acutely mentally ill patients

Learning Objective #2: Identify two challenges to conducting health disparities research in ethnically diverse communities

---

The topic of health disparities and acute mental illness in Hawaii's ethnically diverse population is poorly understood. This study addressed this knowledge gap by exploring differences in personal characteristics, mental health, functional health, treatment and care involving Caucasians, Asians, and Pacific Islanders who were hospitalized for an acute mental illness in Hawaii during a two-year period ending in 2003. A total of 138 subjects were enrolled in the study, including 48 who identified themselves as being primarily of Asian background, 43 who identified themselves as being primarily of Native Hawaiian/Pacific Islander and/or Mixed “Local” background, and 47 whose primary identification was Caucasian. These totals included 62 females and 76 males. The methodology involved assessment of mental health status within 48 hours of admission and at the time of discharge using the Brief Psychiatric Rating Scale (BPRS); functional assessment at discharge using the Short Form 36 Health Survey Version Two (SF-36v2); assessment of patient satisfaction at discharge using the Perceptions of Care instrument (POC); and a 30-day post-hospitalization retrospective record review using the Psychiatric Records Abstract Instrument (PRAI). Analysis included both descriptive and inferential statistics. The findings revealed a high level of consistency in diagnosis, BPRS change scores, functional health scores and patient satisfaction between members of the three ethnic/racial groups. Statistically significant differences were found between the various ratings and assessments on the basis of gender and socioeconomic status. In addition to the primary research results, the study highlighted several secondary, yet important research challenges. These challenges included balancing divergent requests from multiple human subjects committees, implementing competency testing, addressing numerous personnel concerns, and carefully reviewing how to best define ethnicity within an increasingly mixed ethnic community.