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RESEARCH WEEKLY: Overrepresentation of Black Patients in First Episode Psychosis Programs
By Shanti Silver
(February 1, 2023). Studies of racial differences in health care have repeatedly found that Black Americans have decreased access to mental health services compared to the general population. However, few studies have examined racial differences in interventions for early psychosis. A recent study from Psychiatric Services found that Black patients were overrepresented in coordinated-specialty care programs for early psychosis. This suggests that the underrepresentation of Black patients in other types of mental health services may not apply to coordinated-specialty care interventions for early psychosis.
Methods
This research was conducted on 35 coordinated-specialty care programs for early psychosis. All programs received funding from Community Mental Health Block Grants. To determine whether Black patients were equally represented in these programs, the researchers determined the program’s service area, which is the area where most patients live. The researchers then calculated the percentage of Black people who live in the service area and compared it to the percentage of Black patients in the coordinated-specialty care program.
Key findings
Researchers found that 71% of programs disproportionately served Black patients, relative to the proportion of Black people in their service area. Researchers also found that Black patients and non-Black patients were equally likely to receive Medicaid, be on probation or parole and have a history of receiving inpatient, emergency department or crisis center services in the six months before entering the early psychosis program.
Implications
The researchers suggest that because there was no relationship between the percentage of Black patients and factors such as hospitalizations, Medicaid recipiency or recent criminal justice involvement, there is no clear explanation for the overrepresentation of Black patients in coordinated-specialty care programs for early-psychosis. However, while reasons for the overrepresentation of Black patients is unclear, the researchers state that Black patients who experience early psychosis appear to be able to access and utilize these effective, evidence-based programs. This finding is especially significant given that Black patients are generally less likely than the general population to receive timely and effective treatment for mental health-related problems.
Based on these findings, the researchers recommend that coordinated-specialty care programs for early-psychosis aim to provide responsive, culturally sensitive care to their patients, especially if they are not used to working with Black families.
References
Daley, T. C., et al. (December 2022). Client Racial Composition in First-Episode Psychosis Programs Compared with Compositions in Program Service Areas. Psychiatric Services.
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