Cultural Aspects of Psychiatric Clinic Utilization a Cross-Cultural Study in Hawaii

Data was obtained by ethnic status from 411 outpatients at a psychiatric clinic in Honolulu, Hawaii, and were then analyzed according to demographic variables, welfare status, source of referral, primary compliants or symptoms, diagnosis, and duration of treatment received. Clinic utilization was highly related to ethnicity, with Caucasians highly over-represented in proportion to the population, and other groups, especially Japanese, being greatly under-represented. The Caucasians were more likely to be self-referred, to have subjective symptoms of anxiety and depression, and to receive a neurotic diagnosis. The Japanese, and to some extent all other groups, were more often referred after a crisis or severe mental illness, displayed more socially disruptive symptoms, and had a higher percentage of schizophrenic diagnoses. Ethnicity was thus highly related to utilization of mental health services; however, once entry into the system was made, review of therapist case loads and analysis of duration of treatment revealed no ethnic difference in the clinic's response to patients.