RESEARCH WEEKLY: Family Involvement in Early Psychosis Care
By Elizabeth Sinclair Hancq
(April 14, 2021) Families provide important support to individuals living with severe mental illness. Not only do families play a vital role in recognizing early signs and symptoms but research indicates that higher levels of family support can improve outcomes for individuals with schizophrenia and bipolar disorder.
The majority of individuals enrolled in an early psychosis care program prefer to have their families involved in their treatment, according to new research published this month in Psychiatric Services. Conversely, the individuals who preferred no or little family involvement were more likely to be discharged early from the program, the study results show. Together, the results reinforce the vital role of family support in individuals with severe mental illness, especially during the early stages of their illness.
A deeper dive into the study
The study authors from University of South Florida, Tampa and New York State Psychiatric Institute reviewed administrative data from 21 different OnTrackNY programs, a statewide coordinated specialty care program for individuals with first episode psychosis. The study involved data from 761 individuals who had enrolled in this early intervention in psychosis services program between August 2015 and December 2017. The authors examined both the participant’s preference in family involvement in their care as well as actual family contact with the coordinated specialty care team over the course of their treatment.
At enrollment, 59% of individuals requested that their family be involved in their treatment, 35% requested that their family be involved on some conditions, whereas 6% requested no family involvement. Compared to people who requested some family involvement, people who preferred no family involvement were more likely to be older, experience homelessness or live alone. A higher proportion of early discharges from the program were of individuals who requested no family involvement, according to the study results, suggesting this may be a predictor of treatment disengagement in individuals with first episode psychosis.
Rates of family contact with the coordinated specialty care program staff decreased over time: 84% of individuals enrolled had some family contact after three months of being enrolled, whereas 73% had some family contact after 12 months.
There were significant differences in rates of family contacts of individuals enrolled in this early intervention in psychosis program based on sociodemographics. Family members of Black participants had lower contact rates as well as people who were uninsured or receiving public insurance.
The results suggest that there are “potential racial and socioeconomic inequities in the capacity of families to be involved in services,” the authors write. “Expanded research on how best to optimize involvement of the families of diverse clients remains a priority for the field.”
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