Racial-Ethnic Disparities in First-Episode Psychosis Treatment Outcomes From the RAISE-ETP Study

Oluwoye, Oladunni; Stiles, Bryan; Monroe-DeVita, Maria; Chwastiak, Lydia; McClellan, Jon; Dyck, Dennis G.; Cabassa, Leopoldo J.; McDonell, Michael G.

doi:10.1176/appi.ps.201800067

Cited by 68 publications

(42 citation statements)

References 43 publications

(37 reference statements)

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“…Our findings are also relevant to international policies on mental health. For example, a widespread of early psychosis services in the United States is ongoing therefore; deploying early psychosis service with a whole community approach (set out earlier) in mind will be effective in meeting the needs of those who need such services the most, as well as addressing ethnic disparities in psychosis outcomes [ 61 ]. A long duration of untreated psychosis is also a reflection of an onset that goes unnoticed because the person has limited social network.…”

Section: Discussionmentioning

confidence: 99%

Ethnic variations in duration of untreated psychosis: report from the CRIS-FEP study

Oduola

Craig

Morgan

2020

Soc Psychiatry Psychiatr Epidemiol

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Objectives There is inconsistent evidence on the influence of ethnicity on duration of untreated psychosis (DUP). We investigated ethnic differences in DUP in a large epidemiological dataset of first episode psychosis patients in an inner city area of south London, UK. Methods We analysed data on 558 first episode psychosis patients at the South London and Maudsley NHS Trust, between 2010 and 2012. We performed multivariable logistic regression to estimate the odds of a short DUP (≤ 6 months) by ethnic group, controlling for confounders. Results There was no evidence that ethnicity is associated with duration of untreated psychosis. However, we found evidence that a short DUP was strongly associated with age, living circumstances, and pathways to care variables (involuntary admission, out of office hour contact, accident and emergency referral, criminal justice agency referral and family involvement in help-seeking). Conversely, a long DUP was associated with report of social isolation, living alone, being single and General Practitioner referral. Conclusion Our findings suggest that indicators of social isolation were associated with long DUP. Our data also show that pathways into care characteristics play significant role in DUP. Thus, the challenge of tackling the issue of timely access to EI under the new Access and Waiting Time standard for psychosis requires a multilevel approach, including joint working with communities, public awareness of psychosis, less restrictive referral pathways and adequate resourcing of early intervention for psychosis services. These will go a long way in addressing patients' needs rather than be determined by service structures.

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Section: Discussionmentioning

confidence: 99%

Ethnic variations in duration of untreated psychosis: report from the CRIS-FEP study

Oduola

Craig

Morgan

2020

Soc Psychiatry Psychiatr Epidemiol

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“…One strength of the sample was its representation of gender diversity, as nearly a fifth of the sample identifying as non-binary, and one in ten identifying as transgender. While our study provides a starting point to understand overall trends for young adults with EP, development and dissemination work should also incorporate insights from studies focused in-depth on the experiences of underrepresented groups, particularly considering racial-ethnic service disparities in both specialty and community care for psychosis (Oluwoye et al, 2018 ). Our results are also limited by the lack of a non-EP comparison group; thus, they cannot speak to whether the preferences identified here for individuals with early psychosis differ from those of young adults with other mental health symptoms or in the non-clinical population.…”

Section: Discussionmentioning

confidence: 99%

mHealth for Young Adults with Early Psychosis: User Preferences and Their Relationship to Attitudes About Treatment-Seeking

Buck

Chander

Tauscher

et al. 2021

J. technol. behav. sci.

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A long duration of untreated psychosis reduces benefits of early intervention for early psychosis. Digital technologies have potential to encourage help-seeking and reduce barriers to care. Because of high rates of smartphone ownership, mobile health (mHealth) interventions may be particularly well-suited to increase access. There is a lack of available information on the specific features that may be most appealing to young adults with early psychosis. The present study remotely recruited 77 young adults with psychosis and surveyed their interest in mHealth features, delivery modalities, and attitudes toward treatment. Overall, respondents reported high utilization of digital health and high interest in psychosis-specific mHealth. They expressed the highest interest (ordered by mean score by item) in information about medications and side effects ( n = 69, 89.6% reporting being “interested” or “very interested”), managing stress and improving mood ( n = 67, 89.3%) and symptoms of psychosis ( n = 66, 88%), as well as in tracking changes in symptoms ( n = 70, 90.9%), and goals ( n = 66, 86.9%). They also reported high interest in content being delivered as text ( n = 69, 89.6%) and also in communicating directly with providers. Respondents were less interested in social features, and those with most negative attitudes toward help-seeking had particularly low interest in features related to disclosing symptoms to others. These results suggest mHealth may have potential to engage individuals with early psychosis, and that the most effective strategies may be those that are most straightforward, including direct psychoeducational information.

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“…17 18 For instance, in a large clustered randomised trial of NAVIGATE, a CSC programme for FEP, 69% of family members did not participate in family psychoeducation and only 29% attended five or more appointments. 19 20 These findings also revealed that racial/ethnic minority families engaged in treatment at lower rates than non-Hispanic whites. 19 We need to better understand and systematically address factors and underlying mechanisms that affect the successful implementation of family-based interventions in mental health settings.…”

Section: Introductionmentioning

confidence: 89%

“…Based on previously collected and published data that informed IM step 1 (problem analysis), 19 SDT was chosen as an overarching theoretical framework to ensure that the intervention’s underlining mechanism of motivation is targeted by incorporating specific components, such as motivational statements, an approach consistent with IM step 2 (review of theory-based methods and practical strategies). 56 SDT focuses on three fundamental human needs: autonomy (choice), competence (self-efficacy) and relatedness (belonging).…”

Section: Methods and Analysismentioning

confidence: 99%

“…19 20 These findings also revealed that racial/ethnic minority families engaged in treatment at lower rates than non-Hispanic whites. 19 We need to better understand and systematically address factors and underlying mechanisms that affect the successful implementation of family-based interventions in mental health settings.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

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Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol

et al. 2020

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IntroductionDespite the proven effectiveness of coordinated specialty care (CSC) programmes for first episode psychosis in the USA, CSC programmes often have low levels of engagement in family psychoeducation, and engagement of racial and ethnic minority family members is even lower than that for non-Latino white family members. The goal of this study is to develop and evaluate a culturally informed FAmily Motivational Engagement Strategy (FAMES) and implementation toolkit for CSC providers.Methods and analysisThis protocol describes a mixed methods, multi-phase study that blends intervention mapping and the Promoting Action on Research in Health Services framework to develop, modify and pilot-test FAMES and an accompanying implementation toolkit. Phase 1 will convene a Stakeholder Advisory Committee to inform modifications based on findings from phases 1 and 2. During phase 1, we will also recruit approximately 200 family members to complete an online survey to assess barriers and motivation to engage in treatment. Phase 2 we will recruit five family members into a 3-month trial of the modified FAMES and implementation toolkit. Results will guide the advisory committee in refining the intervention and implementation toolkit. Phase 3 will involve a 16-month non-randomised, stepped-wedge trial with 50 family members from five CSC programmes in community-based mental health clinics to examine the acceptability, feasibility and initial impact of FAMES and the implementation toolkit.Ethics and disseminationThis study received Institutional Review Board approval from Washington State University, protocol #17 812–001. Results will be disseminated via peer review publications, presentations at national and international conferences, and to local community mental health agencies and committees.Trial registration numberClinicalTrials.gov Registry (NCT04188366).

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Racial-Ethnic Disparities in First-Episode Psychosis Treatment Outcomes From the RAISE-ETP Study

Cited by 68 publications

References 43 publications

Ethnic variations in duration of untreated psychosis: report from the CRIS-FEP study

Ethnic variations in duration of untreated psychosis: report from the CRIS-FEP study

mHealth for Young Adults with Early Psychosis: User Preferences and Their Relationship to Attitudes About Treatment-Seeking

Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol

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