T242. THE TIMING OF FIRST HELP-SEEKING ATTEMPT IN FIRST EPISODE PSYCHOSIS CAN LEAD TO AVERSIVE PATHWAYS TO CARE. RESULTS FROM THE STEP-ED STUDY

• Published in: Schizophrenia bulletin 2020-05, Vol.46 (Supplement_1), p.S324-S325
• Main Authors: Ferrara, Maria, Guloksuz, Sinan, Mathis, Walter, Raballo, Andrea, Li, Fangyong, Lin, I-Hsin, Syed, Sumaiyah, Gallagher, Keith, Woods, Scott, Tek, Cenk, Srihari, Vinod
• Format: Article
• Language: English
• Subjects: Poster Session III
• ISSN: 0586-7614; 1745-1701
• DOI: 10.1093/schbul/sbaa029.802

Abstract Background In the U.S., individuals affected by a first episode psychosis endure 74 mean weeks of delay in receiving effective treatment. Facilitating their access to care has become a public health priority. This delay has proven to have adverse consequences both in short and long-term outcomes. Moreover, aversive pathways to care can imperil subsequent engagement with treatment. A better understanding of how a patient’s characteristics might influence interactions with healthcare systems could help tailor early detection interventions and target delays in treatments. By comparing the timing of the first help seeking attempt initiated in a sample of first episode psychosis participants of an early detection campaign, we aim to investigate if people starting to seek help before psychosis will have shorter delays to care, and if an earlier help-seeking attempt correlates with a lower rate of adverse pathways to care (e.g. police involvement, involuntary admissions). Methods Participants were recruited starting February 1st, 2014 to January 31st, 2019, to STEP, a Coordinated Specialty Care Program in New Haven, CT. Based on the date of the first help-seeking episode, demographic, clinical, and socioeconomic data were used to compare participants who had their first help-seeking attempt before or after psychosis onset (psychosis onset defined using the POPS criteria at the SIPS Interview). Chi-square test was used to compare categorical variables; non-parametric or Student’s t test was used to compare the continuous variables. Results The sample comprised 168 subjects, the majority of which were male, African American, young adults (mean age was 22.4, SD=3.8), with a median time from psychosis onset to first antipsychotic of 52 days [IQ range, 15 – 196], and had their first help-seeking attempt after psychosis onset (70%). Between the two groups there was no difference in sociodemographic characteristics, in psychosis diagnosis, and in the global assessment of functioning (at baseline and 12 months prior). Help-seeking attempts made before psychosis onset were mostly initiated by the patients themselves, while attempts made after onset had the family as the prime initiator. Once the first help-seeking attempt was initiated, it took longer to get prescribed an antipsychotic for subjects seeking help before onset compared to those who sought help after (median 245 days [5 – 1400] vs. 1 day [0 – 999], p