“No data, no problem”? Potential inequities in psychosis among immigrants in the United States

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 Westernized 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. 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 the 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. • Global evidence finds inequities in psychosis among immigrants compared to non-immigrants but there is limited research on this phenomenon in the United States • Evidence from other countries shows these preventable inequities are due in large part to social adversities such as socioeconomic disadvantage, discrimination, and trauma; no other potential explanations have been substantiated yet • U.S. federal research funding for psychosis has primarily focused on biomedical causes and early intervention, contributing to the minimal attention on immigrants • Domestic data collection and research on psychosis among immigrants in the United States is urgently needed to mitigate and address these preventable inequities • Any research efforts must center the autonomy and self-determination of participants, given the documented harms of coercive care on the rise nationally