Functional impairment, mental disorder symptomatology, and perceived bias among racial and ethnic minorities in the United States

Mental health disparities in the U.S. among racial and ethnic minorities are a serious public health issue associated with substantial ethical and economic costs as well as negative health outcomes. Compared with Whites, racial/ethnic minorities have been found to have greater mental disorder symptomatology, however, very little research exists on how this impacts functional outcomes and quality of life. Additionally, research addressing the impact of bias on symptomatology and functional outcomes, especially across racial/ethnic groups, is lacking. Using the International Classification of Functioning, Disability, and Health (ICF) Biopsychosocial Model of Disability as a conceptual framework, the current study aims to address the relationship between mental disorder symptomatology and functional impairment across racial/ethnic groups, as well as evaluate the influence of perceived bias on this association. These relationships were examined using data from the Collaborative Psychiatric Epidemiological Surveys (CPES) among White, Black, Latinx, and Asian American individuals (N = 10,276). Variables include past-30-day functional impairment, past-year mental disorder symptomatology, and lifetime perceived bias. One-way analyses of variance were conducted to compare mental disorder symptomatology and perceived bias across racial/ethnic groups. Pearson correlation analyses were conducted to assess the relationship between mental disorder symptomatology and functional impairment across racial/ethnic groups. Zero-inflated negative binomial regressions were conducted to evaluate the moderating effect of perceived bias on the relationship between mental disorder symptomatology and functional impairment across racial/ethnic groups. Additional exploratory analyses were conducted to assess the relationships between mental disorder symptomatology, perceived bias, and various domains of functional impairment across racial/ethnic groups. Findings speak to the need for additional research on predictors and correlates of mental health outcomes, such as social support, community, and other resiliency factors. Additionally, the need for broader conceptualizations of how bias, prejudice, stigma, and intersectional identity may impact health and wellbeing across diverse populations is illustrated in this work. Overall, findings indicate the continued existence of disparities in mental health across racial/ethnic groups and reify the need for additional work to address this public health problem.