Objectives: New York City (NYC) is home to the largest Asian community in New York State. However, Asian Americans/Pacific Islanders (AAs/PIs) remain understudied in mental health research. This study assessed the severity of serious psychological distress (SPD) and its association with demographic characteristics among non-Hispanic AAs/PIs in NYC.

Methods: Data from the 2019-2020 New York City Community Health Survey, the only data for AAs/PIs in NYC, were analyzed. Psychological distress was assessed using the Kessler Psychological Distress Scale (K6) in the past 30 days and categorized into three levels: low (0-7), moderate (8-12) and high (≥13), with high SPD potentially indicating the need for medical attention. Weighted and age-adjusted estimates, standardized to the 2000 U.S. Standard Population using four age groups (18-24, 25-44, 45-64, 65+), were used to describe SPD prevalence. Multiple logistic regression was used to examine factors associated with high SPD, while accounting for the survey design.

Results: Among 2,467 AA/PIs, the majority were aged 25-44 years old (43.4%), 86.2% were foreign-born, and 33% had a bachelor’s degree or higher. Overall, 5.5% (95%CI: 4.1%, 7.4%) reported experiencing high SPD, and 9.5% (95%CI: 7.9%, 11.5%) had moderate SPD. In the adjusted model, factors associated with higher odds of high SPD included sexual orientation (lesbian/gay/bisexual: aOR=14.92, 95%CI: 5.38, 41.34 vs. heterosexual individuals), marital status (widowed: aOR=4.86, 95%CI: 1.11, 21.23; separated: aOR=6.07, 95%CI: 1.95, 18.90 vs. married individuals), and subgroups (Asian Indian: aOR=5.12, 95%CI: 2.23, 11.78; Filipino: aOR=6.64, 95%CI: 1.98, 22.26; and Korean: aOR=6.49, 95%CI: 1.29, 32.66 vs. Chinese). No significant associations were observed between high SPD and age, sex, nativity, education level, or employment status.

Conclusions: Culturally tailored mental health programs should prioritize groups identified as lesbian/gay/bisexual, widowed or separated individuals, and specific AA/PI subgroups, including Asian Indian, Filipino, and Korean.