1.30 Psychiatric Diagnoses and Clinical Characteristics of Asian American Youth Admitted to a New York City Child and Adolescent Psychiatry Inpatient Unit

Although Asian American (AA) youth comprise the fastest growing racial minority group in the United States, their mental health status and needs have not been widely studied. We compared the psychiatric diagnoses, clinical characteristics, and sociodemographics of AA and non-AA child and adolescent psychiatry inpatients. Based on prior literature on psychiatric admissions among AA adults, we hypothesized that AA youth were more likely than non-AA youth to be hospitalized for more serious mental health problems. Sociodemographics, psychiatric history, and clinical information from admission were extracted from charts of youth (n = 1101) admitted to a 17-bed child and adolescent psychiatry unit in New York City from June 2018 to November 2021. Our analyses included descriptive statistics, Pearson’s χ2 tests, and independent t tests. Of the patients admitted, 65 (5.9%) identified as AA. Compared to non-AA patients, AA patients were older (mean age 15 vs 13.9 years; p < .001), less likely to be enrolled in Medicaid (55.4% vs 73.2%; p < .01), and less likely to have a history of Administration for Children’s Services (ACS)/Child Protective Services (CPS) involvement (24.6% vs 41.2%; p < .01). On admission, AA patients had a lower number of prior hospitalizations (mean 0.34 vs 0.88; p < .001) and home medications (mean 0.68 vs 0.97; p = .03) and were less likely to have a prior psychiatric diagnosis (64.6% vs 77.1%; p = .02). They were less likely to have a history of ADHD (7.7% vs 30%; p < .001), impulsive/behavioral disorder (6.2% vs 16.4%; p = .03), substance use (15.4% vs 27.5%; p = .03), trauma (33.9% vs 49.8%; p = .01), or violence (18.5% vs 33.4%; p = .01). AA youth were more likely to be admitted for psychosis (16.9% vs 6%; p < .001) and less likely for aggression (9.2% vs 21%; p = .02). There were no differences in length of stay on the unit, history of mood, anxiety, or psychotic disorders, and history of self-harm or suicide attempt. While AA youth were less likely to be diagnosed with ADHD, they were more likely to be admitted for psychosis. AA youth and their caregivers may postpone treatment until more serious mental health issues arise, potentially due to language barriers, mistrust, perceived racism, and varying cultural definitions of distress and mental health. These racial disparities in psychiatric diagnoses and clinical characteristics necessitate further consideration of possible systemic, social, and cultural contributing factors.