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Ehntholt A, Rodgers IT, Lekas HM, Lewis-Fernández R, Samaranayake D, Anderson A, Capobianco L, Cohen DE, Feeney S, Leckman-Westin E, Marinovic S, Pritam R, Chen S, Smith TE, Dixon LB, Saake A. Disparities in COVID-19-Related Psychological Distress Among Recipients of a State's Public Mental Health Services. Psychiatr Serv 2024; 75:444-450. [PMID: 37960865 DOI: 10.1176/appi.ps.20230025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
OBJECTIVE The authors examined changes in perceived anxiety, stress, and mental health symptoms (i.e., psychological distress) reported by recipients of New York State public mental health services during the early months of the COVID-19 pandemic, as well as whether these changes varied by demographic characteristics or pandemic-related socioeconomic challenges. METHODS A statewide survey of service recipients (N=3,483) was conducted (May 8-June 22, 2020). Descriptive analyses were summarized, and logistic regression was used to evaluate associations between increases in reported psychological distress and age, gender, region of residence, race and ethnicity, socioeconomic challenges, and alcohol or drug use. RESULTS Fifty-five percent of respondents (N=1,933) reported a slight or moderate increase in COVID-19-related psychological distress, and 15% (N=520) reported a substantial increase. In adjusted models, substantial elevations in psychological distress were associated with identifying as female (AOR=1.83, 95% CI=1.50-2.25), experiencing three or more pandemic-related socioeconomic challenges (AOR=2.41, 95% CI=1.91-3.03), and reporting increased use of alcohol or drugs (AOR=1.81, 95% CI=1.34-2.44). Compared with non-Hispanic/Latinx White service recipients, non-Hispanic/Latinx Black individuals had lower odds of reporting substantially increased psychological distress (AOR=0.59, 95% CI=0.45-0.76), as did non-Hispanic/Latinx Asian-descent individuals (AOR=0.28, 95% CI=0.12-0.64). CONCLUSIONS In this large sample of recipients of New York State public mental health services, the COVID-19 pandemic's impact on psychological well-being was widespread and varied by gender, race and ethnicity, and socioeconomic vulnerability. These relationships must be considered in ongoing efforts to provide optimal care for this population.
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Affiliation(s)
- Amy Ehntholt
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Ian T Rodgers
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Helen-Maria Lekas
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Roberto Lewis-Fernández
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Dhanushki Samaranayake
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Adrienne Anderson
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Linda Capobianco
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Dana E Cohen
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Suzanne Feeney
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Emily Leckman-Westin
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Sonia Marinovic
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Riti Pritam
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Shuo Chen
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Thomas E Smith
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Lisa B Dixon
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
| | - Amanda Saake
- New York State Office of Mental Health, Albany (Ehntholt, Rodgers, Samaranayake, Anderson, Cohen, Feeney, Leckman-Westin, Marinovic, Pritam, Chen, Smith, Dixon, Saake); New York State Psychiatric Institute, New York City (Rodgers, Lewis-Fernández, Anderson, Cohen); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Ehntholt, Lewis-Fernández, Smith, Dixon); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Lekas, Capobianco)
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Cheslack-Postava K, Forthal S, Musa GJ, Ryan M, Bresnahan M, Sapigao RG, Lin S, Fan B, Svob C, Geronazzo-Alman L, Hsu YJ, Skokauskas N, Hoven CW. Persistence of anxiety among Asian Americans: racial and ethnic heterogeneity in the longitudinal trends in mental well-being during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 2024; 59:599-609. [PMID: 37624465 DOI: 10.1007/s00127-023-02553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE To examine within-individual time trends in mental well-being and factors influencing heterogeneity of these trends. METHODS Longitudinal telephone survey of adults over 3 waves from the New York City (NYC) Metropolitan area during the COVID-19 Pandemic. Participants reported depression using the Patient Health Questionnaire (PHQ)-8, anxiety using the Generalized Anxiety Disorder (GAD)-7, and past 30-day increases in tobacco or alcohol use at each wave. Adjusted mixed effects logistic regression models assessed time trends in mental well-being. RESULTS There were 1227 respondents. Over 3 study waves, there were statistically significant decreasing time trends in the odds of each outcome (adjusted OR (95% CI) 0.47 (0.37, 0.60); p < 0.001 for depression; aOR (95% CI) 0.55 (0.45, 0.66); p < 0.001 for anxiety; aOR (95% CI) 0.50 (0.35, 0.71); p < 0.001 for past 30-day increased tobacco use; aOR (95% CI) 0.31 (0.24, 0.40); p < 0.001 for past 30-day increased alcohol use). Time trends for anxiety varied by race and ethnicity (p value for interaction = 0.05, 4 df); anxiety declined over time among white, Black, Hispanic, and Other race and ethnicity but not among Asian participants. CONCLUSIONS In a demographically varied population from the NYC Metropolitan area, depression, anxiety and increased substance use were common during the first months of the pandemic, but decreased over the following year. While this was consistently the case across most demographic groups, the odds of anxiety among Asian participants did not decrease over time.
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Affiliation(s)
- Keely Cheslack-Postava
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA.
| | - Sarah Forthal
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - George J Musa
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Megan Ryan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Michaeline Bresnahan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Rosemarie G Sapigao
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- CUNY Graduate School of Public Health and Health Policy, New York, USA
| | - Susan Lin
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Bin Fan
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Connie Svob
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lupo Geronazzo-Alman
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Yi-Ju Hsu
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
| | - Norbert Skokauskas
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Christina W Hoven
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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Nguyen-Truong CKY, Wuestney K, Leung H, Chiu C, Park M, Chac C, Fritz RL. Toward Sustaining Web-Based Senior Center Programming Accessibility With and for Older Adult Immigrants: Community-Based Participatory Research Cross-Sectional Study. Asian Pac Isl Nurs J 2024; 8:e49493. [PMID: 38277216 PMCID: PMC10858412 DOI: 10.2196/49493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, many community-based organizations serving Asian Americans pivoted to provide web-based care and social services. Asian American community leaders in the United States Pacific Northwest, including Asian Health & Service Center expressed that there are older immigrant adults who experienced backlash from discrimination, fear, and anxiety owing in part to anti-Asian hate and isolation, including from infection precautions. Pivoting supported staying safe from COVID-19 transmission and anti-Asian hate crimes. OBJECTIVE This study aims to examine the readiness of diverse groups of older Asian American immigrant adults (Chinese, Koreans, and Vietnamese) to use a web-based senior center, including technology access and telehealth use, and to identify the psychosocial health impacts that a web-based senior center could be positioned to meet. METHODS A community-based participatory research approach was used to conduct a cross-sectional survey study in an Asian-based health and service center in 2022. We selected surveys from the National Institutes of Health-supported PhenX Toolkit. Analyses were performed using R software. RESULTS There was an 88.2% (216/245) response rate. Overall, 39.8% (86/216) of participants were Chinese, 25% (54/216) were Korean, and 24.5% (53/216) were Vietnamese. There were significant group differences in mobile data plans (P=.0005). Most had an unlimited mobile data plan (38/86, 44% Chinese; 39/54, 72% Koreans; 25/53, 47% Vietnamese). Significant group differences existed regarding whether they started using a new electronic device to communicate with friends or family after the COVID-19 outbreak (P=.0005); most were Korean participants (31/54, 57%). For written text and audio or video apps, most Chinese participants used WeChat (65/85, 76%; 57/84, 68%, respectively), most Koreans used KakaoTalk (49/54, 91%; 49/54, 91%, respectively), and most Vietnamese used Facebook Messenger for written text (32/50, 64%) and Apple Face Time (33/50, 66%) or Facebook Messenger (31/50, 62%) for audio or video. Significant group differences existed regarding whether to try telehealth (P=.0005); most Vietnamese expressed that they would never consider it (41/53, 77%). Significant group differences existed regarding how well they were able to concentrate (χ22=44.7; P<.0001); Chinese participants reported a greater inability (median 5, IQR 4-6). With regard to difficulties in life experiences (χ22=51; P<.0001), the median was 6 (IQR 5-7) for the Vietnamese group. Significant group differences existed in having had a family/household member's salary, hours, and contracts reduced (P=.0005) and having had a family/household member or friend fallen physically ill (P=.0005)-most Vietnamese (15/53, 28%) and Korean participants (10/53, 19%). CONCLUSIONS To build an efficacious, web-based senior center with web-based care and social service options, more older adults need access to the internet and education about using technology-enabled communication devices. Addressing the unique psychosocial impacts of the COVID-19 pandemic on each group could improve health equity. The strength of the participating older adults was observed and honored.
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Affiliation(s)
- Connie Kim Yen Nguyen-Truong
- Nursing and Systems Science Department, College of Nursing in Vancouver, Washington State University, Vancouver, WA, United States
| | - Katherine Wuestney
- PhD in Nursing Program, College of Nursing, Spokane Health Sciences, Washington State University, Spokane, WA, United States
| | - Holden Leung
- Asian Health & Service Center, Portland, OR, United States
| | - Chenya Chiu
- Asian Health & Service Center, Portland, OR, United States
| | - Maria Park
- Asian Health & Service Center, Portland, OR, United States
| | - Christina Chac
- Asian Health & Service Center, Portland, OR, United States
| | - Roschelle Lynette Fritz
- Nursing and Systems Science Department, College of Nursing in Vancouver, Washington State University, Vancouver, WA, United States
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