The specific aim of this investigation is to determine if difference exists between Caucasians, Asians, and Pacific Islanders who are hospitalized for an acute mental illness with regard to: 1) personal characteristics; 2) change scores regarding mental health status between admission and discharge; 3) functional health scores (also compared against USA norms); 4) the quality of inpatient care provided compared to a validated standard of care for; and 5) associations of the above measures with length of hospitalization, hospital charges, age, gender, care for; and 5) associations of the above measures with length of hospitalization, hospital charges, age, gender, payment source, and income within and between these ethnic groups. The sample will be composed of adult patients admitted and diagnos4ed with DSM IV criteria. Participants will be oriented to time, person, place and situation, will be and able to read English, will consent to participate, and will be asked if they are Asian, Pacific, Islander or Caucasian. A stratified random sampling method designed to accomplish the enrollment of 100 participants per ethic group will be used. A research assistant will assess the patient's mental health within 48 hours of admission then again within 24 hours of discharge using the BPRS. Within 24 hours of discharge the patient will complete the SF-36 and Perceptions of Care (satisfaction) instruments. PRAI will be retrospectively completed from the medical record. Statistical analyses will include analysis of variance to compare mental and health outcomes across three ethnic groups. Analysis will also compare the PRAI findings with a validated standard of care. Analysis will also provide adjustments for demographic data and the capacity to explore interactions. For example, an attempt will be made to examine whether demographic characteristics will have a stronger association with a health or institutional outcome in one ethnic group versus another. Results will be interpreted with the intent of achieving a better understanding of how sensitivity to ethnicity and culture may improve response to treatment and prevention interventions.
