Understanding differences in family engagement and provider outreach in New Journeys: A coordinated specialty care program for first episode psychosis

• Published in: Psychiatry research Vol. 291; p. 113286
• Main Authors: Oluwoye, Oladunni, Stokes, Bryony, Stiles, Bryan, Monroe-DeVita, Maria, McDonell, Michael G.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2020
• Subjects: Adult; African Americans - psychology; Community Health Services - methods; Coordinated specialty care; European Continental Ancestry Group - psychology; Family - psychology; Family engagement; Female; First episode psychosis; Health Personnel - psychology; Health Personnel - trends; Healthcare Disparities - trends; Humans; Male; Patient Education as Topic - methods; Psychoeducation; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Psychotic Disorders - therapy; Racial disparities; Social determinants; Washington - epidemiology; Washington; First episode psychosis; Coordinated specialty care; Psychoeducation; Racial disparities; Social determinants; Family engagement
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2020.113286

•70% of family members attended at least one family psychoeducation appointment across 24-months of coordinated specialty care treatment.•40% of family members attended the first month of family psychoeducation.•Clinicians made a significantly higher number of outreach efforts and scheduled a significantly lower number of family psychoeducation appointments for black families compared to white families.•Families with no insurance or public insurance attended a significantly lower number of family psychoeducation appointments compared to those with private insurance. The present study examined clinician outreach efforts to families and family engagement; and predictors of engagement in a coordinated specialty care (CSC) for first episode psychosis. From 2015 to 2019, 211 clients experiencing their first episode of psychosis and their family members received services from New Journeys, a network of CSC programs in the United States. Analyses examined the association between race/ethnicity, insurance type, referral source, housing stability, and outreach efforts and family attendance. Overall, 70% of client family members attended at least one psychoeducation appointment and in the first month of treatment 40% of family members attended family psychoeducation. Outreach efforts including phone attempts (β=1.09; p = 0.02) and phone contact (β=1.10; p = 0.02) were significantly higher for Black families relative to White families; whereas Black families were scheduled less often for a family psychoeducation (β=-0.28; p = 0.02) compared to Whites families. Significant differences in family attendance based on insurance type were also found (p<0.01). Referral source and housing stability were not significant predictors of outreach or attendance. These findings suggest that alternative engagement efforts that extend beyond in-person contact may be needed to continuously engage families, specifically Black families and those with public and no insurance.