Category: Schizophrenia / Psychotic Disorders

Symposium

Pathways to Care for Latinos Experiencing First-Episode Psychosis

Friday, November 17
1:45 PM - 3:15 PM
Location: Indigo Ballroom E, Level 2, Indigo Level

Keywords: Service Delivery | Psychosis / Psychotic Disorders | Hispanic Americans
Presentation Type: Symposium

Background:  Our study describes the pathways to mental health care of a sample of U.S. Latinos with first episode psychosis (FEP) and we test the applicability of Rogler and Cortes’ (1993) conceptual model of pathways to care.


Methods:  A total of 21 persons with FEP and 19 of their caregivers, all of whom identified as Latino/a, were chosen from a parent study assessing a community campaign to reduce the duration of untreated psychosis in Latinos residing in Los Angeles County.  The clinical sample was comprised of primarily men (81%) with a mean age of 27.81 years whereas the caregiver sample was comprised of largely women (89%) with a mean age of 43.3 years. Semi-structured interviews were analyzed by 5 researchers using a priori coding. This coding process described the contacts made on the path to care and their fit with the Rogler and Cortes conceptual model. We developed visual diagrams of each dyad’s pathways to care described as roadmaps (Fox & Myers, 2016).


Results:  Most Latino patients (90%) experiencing FEP received initial treatment through involuntary inpatient care resulting from a crisis and/or police involvement. The visual diagrams of the pathways include both simple models (19%) of initial crisis to hospitalization and then follow-up with outpatient care, as well as complex ongoing cycles (81%) inclusive of paths between various personal and professional social networks, and multiple mental health institutions. In many cases, the pathways continue after initial contact with mental health facilities, most of which offered involuntary treatment.


Conclusions:  The role of involuntary treatment should be included to the Rogler and Cortes model when applied to first episode psychosis. The number of cases with ongoing pathways following initial contact with mental health providers argues for an early psychosis treatment unit that closely monitors and facilitates treatment engagement.

Maria Hernandez

Assistant Professor of Social Work
California State University, Los Angeles

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