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Mental health disparities, mechanisms, and intervention strategies

perspective from Hawai‘i

Guerrero, Anthony P.S.; Chock, Shaylin; Lee, Awapuhi K.; Sugimoto-Matsuda, Jeanelle; Kelly, Amanda S.

doi: 10.1097/YCO.0000000000000551

Purpose of review Although there is a growing body of literature describing the scope and impact of mental health disparities, there is relatively less literature focused on youth and on interventions that are grounded in the cultures of youth most significantly affected by disparities. From the perspective of Hawai‘i, one of the world's most diverse communities where disparities nonetheless exist, the authors review the varieties of diversity encountered in psychiatry and healthcare, specific youth mental health disparities, and examples of locally tailored solutions.

Recent findings Mental health disparities are born from the differential exposures to poverty, trauma, discrimination, and barriers to accessing care, especially mental healthcare, which is nationally in short supply. They exist even in supposedly high-resource settings and significantly impact indigenous populations, including in terms of risk for incarceration and risk for suicidal behavior.

Summary Addressing disparities involves insuring access to preventive and treatment-focused mental healthcare and applying cultural humility in clinical and community settings. The authors add to the reviewed literature by highlighting interventions that are population-based, culturally grounded, and focused on indigenous youth.

Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, Hawai‘i, USA

Correspondence to Anthony P.S. Guerrero, Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i, 1356 Lusitana St., 4th Floor, Honolulu, HI 96821, USA. Tel: +1 808 586 2900; e-mail:

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