Ethnicity, Marginalisation and Mental Illness in Hawaii

This study examines the characteristics, treatment and care of severely and persistently mentally ill patients at Hawaii's largest public sector psychiatric facility, Hawaii State Hospital. The implications of this information are then discussed, in terms of treatment and care. Consistent with previous studies, the 88 patients included in this study were most often male, less than 40 years of age, with a high school education or less, and hospitalized under a penal code. More remarkable variations were revealed, however, when patients were grouped according to ethnicity and racial origin. For example, patients from marginalised groups had a significantly higher likelihood of violence than patients from more politically, economically and socially powerful groups in Hawaii. The findings of this research challenge health care providers in general, and nurses in particular, to combine social advocacy with clinical expertise to ensure that patients receive effective and complete treatment and care.