Characteristics of First-Episode Psychosis Clients across Massachusetts: Inter-Program Differences, Demographics, and Engagement

Alyssa Williamson, BA

Beth Israel Deaconess Medical Center – Research Assistant
Williamson_alyssa poster

Scientific Abstract

Background: Many First-Episode Psychosis (FEP) clients encounter barriers to treatment, with substance use disorders, lack of enrollment in school or work, and legal involvement known to predict engagement difficulties. We sought to assess differences in client populations between FEP programs and the extent to which demographic & clinical characteristics affect engagement with care. We hypothesized that there would be great heterogeneity between 2 spotlight clinics and that client engagement would be reduced in underserved populations.

Methods: We report data from 382 participants across 10 total clinics. Demographic factors were collected at intake and coded dichotomously. The WHO-ASSIST and FEP Census were used to measure cannabis use and client engagement, respectively. Chi square tests of independence assessed differences between Clinics 1 & 2 and the overall sample. Wilcoxon signed rank tests were used to compare average engagement within demographic & clinical variables of interest.

Results: Clinic 1 treats significantly more first- and second-generation immigrants compared to other clinics (χ² = 21.71, p<0.01), while Clinic 2 treats significantly more white and male clients (White: χ²=37.85, p<0.01; Male: χ²=17.36, p<0.01). Clinic 2 also saw significantly fewer clients with active cannabis use (χ²= 7.8, p<0.01) and significantly fewer first- and second-generation immigrants (χ²=12.09, p<0.01) compared to other clinics. Clients using cannabis and those with recent legal involvement showed a significant decrease in overall engagement compared to those without these factors (Cannabis: W= 449.05, p<0.01; Legal: W=7501.5, p=0.02). White clients showed a significant increase in overall engagement compared to non-white clients (W=7601.5, p=0.01).

Conclusions: Our results indicate that clients’ needs vary between clinics, despite all clinics generally having similar resources and treatment approaches. Several sub-groups in this sample (non-white clients, clients using cannabis, and clients with recent legal involvement) showed lower engagement with treatment, which may indicate that current treatment models are not meeting the needs of these populations.

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research Areas


Alyssa N. Williamson, BA, Kelsey A. Johnson, MPH, Margaret Guyer, PhD, Raquelle Mesholam-Gately, PhD, Matcheri Keshavan, MD

Principal Investigator

Raquelle Mesholam-Gately, PhD, Matcheri Keshavan, MD

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