The Mental Health, Substance Use, Physical Health, and Mental Health Treatment Need of Community Individuals Experiencing Homelessness in Hawai‘i

Abstract

Limited research has examined the mental health of individuals experiencing homelessness in Hawai'i, which bears the nation's second highest homelessness rate. Mental health, substance use, treatment need, and health data were collected from 162 unhoused individuals in Hawai'i County by visiting community locations where they congregate (e.g., beaches, vacant buildings). 77% of participants were Native Hawaiian/Pacific Islander (NH/PI) with participants demonstrating severe rates of mental and substance use disorders including 57% experiencing major depressive disorder (MDD), 56% experiencing generalized anxiety disorder (GAD), and 64%, 74%, and 12% experiencing alcohol, methamphetamine, and opioid use disorders, respectively-heightening overdose risk. Treatment need was high (62%) but health was poor (85% reporting fair/ poor health), with MDD and GAD predicting reduced general health (p < 0.05). Study findings indicate Hawai'i unhoused individuals are disproportionately Indigenous NH/PI, enduring striking mental and physical health disparities that may be reduced by increasing access/utilization of community mental health programs/services.

Asian American and Native Hawaiian/Pacific Islander Substance Use and Disparities: Review of Current Evidence and Recommendations for the Field

“…In adults, 2019 NSDUH data revealed low rates of AA-NH/PI past-year use of 1.7% for opioids and > 1% for methamphetamines [88] with a community study of NH/PI adults also finding low rates of current opioid and methamphetamine use of 1% for both substances [29]. Yet, a followup study targeting Hawai′i unhoused individuals-driven by community reports of high NH/PI use in this population-found that over 75% of participants were NH/PI and that this population experienced severe rates of current (1) methamphetamine and illicit opioid use (69% and 24%) and (2) methamphetamine use disorders and OUDs (74% and 12%) [97], revealing key pockets of NH/PIs at great overdose risk who are typically overlooked in national and community studies/data.…”