A Rapid Assessment of the Impact of COVID-19 on Asian Americans: Cross-sectional Survey Study.

BACKGROUND: The diverse Asian American population has been impacted by the COVID-19 pandemic, but due to limited data and other factors, disparities experienced by this population are hidden. OBJECTIVE: This study aims to describe the Asian American community's experiences during the COVID-19 pandemic, focusing on the Greater San Francisco Bay Area, California, and to better inform a Federally Qualified Health Center's (FQHC) health care services and response to challenges faced by the community. METHODS: We conducted a cross-sectional survey between May 20 and June 23, 2020, using a multipronged recruitment approach, including word-of-mouth, FQHC patient appointments, and social media posts. The survey was self-administered online or administered over the phone by FQHC staff in English, Cantonese, Mandarin, and Vietnamese. Survey question topics included COVID-19 testing and preventative behaviors, economic impacts of COVID-19, experience with perceived mistreatment due to their race/ethnicity, and mental health challenges. RESULTS: Among 1297 Asian American respondents, only 3.1% (39/1273) had previously been tested for COVID-19, and 46.6% (392/841) stated that they could not find a place to get tested. In addition, about two-thirds of respondents (477/707) reported feeling stressed, and 22.6% (160/707) reported feeling depressed. Furthermore, 5.6% (72/1275) of respondents reported being treated unfairly because of their race/ethnicity. Among respondents who experienced economic impacts from COVID-19, 32.2% (246/763) had lost their regular jobs and 22.5% (172/763) had reduced hours or reduced income. Additionally, 70.1% (890/1269) of respondents shared that they avoid leaving their home to go to public places (eg, grocery stores, church, and school). CONCLUSIONS: We found that Asian Americans had lower levels of COVID-19 testing and limited access to testing, a high prevalence of mental health issues and economic impacts, and a high prevalence of risk-avoidant behaviors (eg, not leaving the house) in the early months of the COVID-19 pandemic. These findings provide preliminary insights into the impact of the COVID-19 pandemic on Asian American communities served by an FQHC and underscore the longstanding need for culturally and linguistically appropriate approaches to providing mental health, outreach, and education services. These findings led to the establishment of the first Asian multilingual and multicultural COVID-19 testing sites in the local area where the study was conducted, and laid the groundwork for subsequent COVID-19 programs, specifically contact tracing and vaccination programs.

Psychiatry's Dark Secrets: Black Lives Don't Matter.

There have been significant advances in the diagnosis and treatment of psychiatric disorders; however, racial disparities continue to create inequity in mental health care. In this commentary, we explore mental health disparities disfavoring African Americans in the psychiatric literature. We discuss how discrimination over time has resulted in a difference of perception, misdiagnoses, and conflicts in patient care. The literature reviewed reveals a pattern wherein African Americans are more likely to be misdiagnosed for all types of mental illness compared with other ethnicities due to fallacies perpetuated throughout the history of African Americans. In addition, the aggregation of current information and research on the current COVID-19 pandemic will justify future research on the epidemic of police brutality and shootings of unarmed African Americans. If we address this issue, we will reduce medical mistrust and ultimately reduce racial health inequities.

Healthcare services utilization among international students in Ankara, Turkey: a cross-sectional study.

BACKGROUND: While international students form an increasing population of higher education students in Turkey, there is limited empirical evidence about their health services utilization. The study aim was to investigate healthcare access among a group of international students studying in Ankara city and identify potential barriers that affect full healthcare utilization. METHOD: A total of 535 international students from 83 countries completed an online-based questionnaire. The survey was conducted from September until October 2020. Variables between groups within the study sample were compared using ANOVA and Chi-square tests (with Fisher's exact test). Logistic regression analysis was used to evaluate the relationships between variables related to access to health services. RESULTS: Of the study population, 80.6% accessed the general practitioner (GP), 40% accessed the student health centres, and 11.4% were admitted to the hospital at least once. About 80% of international students reported changing their views to access healthcare more because of the COVID-19 pandemic. CONCLUSION: Lack of awareness of healthcare support systems, perceived stigma associated with mental health services, and language barriers were the main barriers affecting healthcare access by international students. IMPLICATIONS: Study findings indicate the need for education of international students on available healthcare, targeted health promotion, and training of health providers on effective communication.

Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020.

In 2019, approximately 51 million U.S. adults aged ≥18 years reported any mental illness,* and 7.7% reported a past-year substance use disorder† (1). Although reported prevalence estimates of certain mental disorders, substance use, or substance use disorders are not generally higher among racial and ethnic minority groups, persons in these groups are often less likely to receive treatment services (1). Persistent systemic social inequities and discrimination related to living conditions and work environments, which contribute to disparities in underlying medical conditions, can further compound health problems faced by members of racial and ethnic minority groups during the coronavirus disease 2019 (COVID-19) pandemic and worsen stress and associated mental health concerns (2,3). In April and May 2020, opt-in Internet panel surveys of English-speaking U.S. adults aged ≥18 years were conducted to assess the prevalence of self-reported mental health conditions and initiation of or increases in substance use to cope with stress, psychosocial stressors, and social determinants of health. Combined prevalence estimates of current depression, initiating or increasing substance use, and suicidal thoughts/ideation were 28.6%, 18.2%, and 8.4%, respectively. Hispanic/Latino (Hispanic) adults reported a higher prevalence of psychosocial stress related to not having enough food or stable housing than did adults in other racial and ethnic groups. These estimates highlight the importance of population-level and tailored interventions for mental health promotion and mental illness prevention, substance use prevention, screening and treatment services, and increased provision of resources to address social determinants of health. How Right Now (Qué Hacer Ahora) is an evidence-based and culturally appropriate communications campaign designed to promote and strengthen the emotional well-being and resiliency of populations adversely affected by COVID-19-related stress, grief, and loss (4).

Changes in pediatric emergency department visits for mental health during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Limited early results indicate that the COVID-19 outbreak has had a significant impact on the mental health of children and adolescents. Pediatric emergency departments (PED) play a pivotal role in the identification, treatment, and coordination of care for children with mental health disorders, however, there is a dearth of literature evaluating the effects of the COVID-19 pandemic on mental health care provision in the PED. OBJECTIVES: We sought to evaluate whether changes in frequency or patient demographics among children and adolescents presenting to the PED has occurred. METHODS: This is a cross-sectional study conducted at the Yale New Haven Children's Hospital (YNHCH) PED. Data representing the early COVID-19 pandemic period was abstracted from the electronic medical record and compared using descriptive statistics to the same time period the year prior. Patient demographics including patient gender, ED disposition, mode of arrival, race-ethnicity, and insurance status were assessed. RESULTS: During the pandemic period, 148 patients presented to the YNHCH PED with mental health-related diagnoses, compared to 378 in the pre-pandemic period, a reduction of 60.84%. Compared to white children, black children were 0.55 less likely to present with a mental health condition as compared to the pre-pandemic study period (p = 0.002; 95% CI 0.36-0.85). CONCLUSIONS: Children with mental and behavioral health disorders who seek care in PEDs may be at risk for delayed presentations of mental health disorders. African American children may be a particularly vulnerable population to screen for mental health disorders as reopening procedures are initiated and warrants further study.

The mental health of those whose rights have been taken away: An essay on the mental health of indigenous peoples in the face of the 2019 Coronavirus (2019-nCoV) outbreak.

Background: : In Latin America there are about 45 million indigenous people in 826 communities that represent 8.3% of the population. An estimated 798,365 Aboriginal and Torres Strait Islander were in Australia, 5,2 million indigenous people living in America and 2,13 million in Canada. Racial/ethnic disparities in mental health service use have increased especially in the context of the new coronavirus pandemic. Thus, we aimed to describe the mental health situation of the indigenous population in the context of the COVID-19 pandemic. Method: : The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and MEDLINE. The data were cross-checked with information from the main international newspapers. Results: : According to the literature, due to the COVID-19 pandemic there is a lack of specialized mental health services and professionals, a restricted access to quality information and a lack of access to inputs, causing negative feelings and it can exacerbate pre-existing mental problems (eg: depression, suicidal ideation, smoking and binge drink). The cultural differences are a risk factor to worsen the mental health of this already vulnerable population. Conclusion: : providing psychological first aid is an essential care component for indigenous populations that have been victims COVID-19 pandemic.

Mental health and COVID-19: is the virus racist?

COVID-19 has changed our lives and it appears to be especially harmful for some groups more than others. Black and Asian ethnic minorities are at particular risk and have reported greater mortality and intensive care needs. Mental illnesses are more common among Black and ethnic minorities, as are crisis care pathways including compulsory admission. This editorial sets out what might underlie these two phenomena, explaining how societal structures and disadvantage generate and can escalate inequalities in crises.