Racial and Ethnic Disparities in the Diagnosis and Early Treatment of First-Episode Psychosis.

Background: Despite recognition that early intervention for first-episode psychosis (FEP) improves outcomes, Black youth with FEP continue to experience critical disparities in care. A historical lack of scientific focus on racial and ethnic factors in the study of psychosis and scant investigations among publicly insured (ie, Medicaid-enrolled) youth hinder our ability to understand and address factors that contribute to disparities in early FEP care. Strategies for improving FEP services for Black youth are reliant on more precise identification of faces disparities and during the early course of illness disparities are experienced.

The Role of Proximity to Coordinated Specialty Care For Early Psychosis And Program Engagement in Washington State: The Interaction of Travel Time, Race, and Ethnicity.

Objective: Proximity to mental health services is a predictor of timely access to services. The present study sought to investigate whether travel time was associated with engagement in coordinated specialty care (CSC) for early psychosis, with specific attention to whether the interaction of travel time by race and ethnicity had differential impact.

Data Source/study Setting: Data collected between 2019 and 2022 as part of the New Journeys evaluation, the CSC model in Washington State.

Multidimensional Approach to Exploring Neighborhood Determinants and Symptom Severity Among Individuals With Psychosis.

Importance: The impact of cumulative exposure to neighborhood factors on psychosis, depression, and anxiety symptom severity prior to specialized services for psychosis is unknown.

Objective: To identify latent neighborhood profiles based on unique combinations of social, economic, and environmental factors, and validate profiles by examining differences in symptom severity among individuals with first episode psychosis (FEP).

Design, Setting, And Participants: This cohort study used neighborhood demographic data and health outcome data for US individuals with FEP receiving services between January 2017 and August 2022.

Implementation support for the data-driven components of care in a multisite network of coordinated specialty care programs.

Beyond training providers prior to the roll-out of coordinated specialty care (CSC) for first-episode psychosis in clinical settings, implementation support for data-informed care remains an area that has received very little attention. The current paper describes the development and refinement of implementation support for the data-driven components of care in the New Journeys network, Washington State's CSC model for psychosis, comprised of 14 CSC programs. Using the Evidence-Based System for Innovation Support Logic Model, this paper outlines the individual components for implementation support, tools, training, technical assistance, and quality improvement/evaluation that have been developed for the New Journeys network.

Exploring service provider perspectives on service user engagement across service components in coordinated specialty care programs for psychosis.

Engagement in services is a core element to successful outcomes for service users and programs. In coordinated specialty care (CSC) programs, designed for individuals experiencing first-episode psychosis, engagement has only been measured programmatically and not by service component. This qualitative study sought to explore provider perspectives on service user engagement in service components of CSC.

Coming together for something good: recommendations from a scoping review for dissemination and implementation science to improve indigenous substance use disorder treatment.

Introduction: Dissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. D&I science offers frameworks, models, and theories to increase implementation success, but research is needed to center Indigenous knowledge, enhancing D&I so that it is more applicable within Indigenous contexts.

An unexplored equity factor: differential beliefs and attitudes toward contingency management by providers' ethnicity.

Background: Although considered one of the most effective interventions for substance use disorders (SUD), the widespread implementation of contingency management (CM) has remained limited. In more recent years there has been surge in the implementation of CM to address increasing rates of substance use. Prior studies at the provider-level have explored beliefs about CM among SUD treatment providers and have tailored implementation strategies based on identified barriers and training needs, to promote implementation of CM.

Reorienting the focus from an individual to a community-level lens to improve the pathways through care for early psychosis in the United States.

The implementation of coordinated specialty care in the U.S. over the past decade has led to the improvements of clinical and functional outcomes among individuals in the early stages of psychosis.

Ethnoracial Differences in Family Members' Early Contact with Formal and Informal Resources on the Pathway to Care during the Early Stages of Psychosis.

The present study examined whether there were ethnoracial differences in the use of formal and informal resources by family members of individuals in the early stages of psychosis. A sample of 154 family member respondents participated in an online cross-sectional survey. Ethnoracially minoritized family members disproportionately made early contact with informal resources (e.

Community-based family peer navigator programme to facilitate linkage to coordinated specialty care for early psychosis among Black families in the USA: A protocol for a hybrid type I feasibility study.

Background: Approximately 70% of Black/African American family members report no contact with mental health providers prior to initial diagnosis and the receipt of services for early psychosis. Black families often encounter barriers and experience delays on the pathway to coordinated specialty care programmes for early psychosis.

Methods And Analysis: This mixed-methods study will (1) develop and refine a family peer navigator (FPN) for Black families designed to increase access and engagement in coordinated specialty care and (2) pilot-test FPN for Black families with 40 family members with loved ones at risk for psychosis in a randomised trial to assess the acceptability and feasibility.

An Unexplored Equity Factor During Pre-Implementation of Contingency Management: Differential Beliefs and Attitudes by Providers' Ethnicity.

Although considered one of the most effective interventions for substance use disorders (SUD), the widespread uptake of contingency management (CM) has remained limited. Prior studies at the provider-level have explored beliefs about CM among SUD treatment providers and have tailored implementation strategies based on identified barriers and training needs. However, there have been no implementation strategies that have actively sought to identify or address potential differences in the beliefs about CM that could be influenced by the cultural background (e.

Barriers to Meaningful Participatory Mental Health Services Research and Priority Next Steps: Findings From a National Survey.

Objective: A growing consensus has emerged regarding the importance of stakeholder involvement in mental health services research. To identify barriers to and the extent of stakeholder involvement in participatory research, the authors undertook a mixed-methods study of researchers and community members who reported participation in such research.

Methods: Eight consultative focus groups were conducted with diverse groups of stakeholders in mental health services research (N=51 unique participants, mostly service users), followed by a survey of service users, family members, community providers, and researchers (N=98) with participatory research experience.

A Multifaceted Technical Assistance Strategy to Facilitate Measurement Delivery in Coordinated Specialty Care.

In recent years, coordinated specialty care (CSC) providers have worked to harmonize and deliver data collection measures across programs so that they can provide data that enable measurement-informed care. However, the strategies that can effectively support the integration of a core assessment battery in clinical care remain unclear. This column presents an evaluation of a multifaceted technical assistance strategy for the delivery and completion of an assessment battery in nine CSC programs (N=247 clients).

Recent substance use among clients with early psychosis and the potential to graduate from New Journeys.

Aim: This study examined the relationship between recent substance use prior to intake and program graduation among young adults with early psychosis enrolled in coordinated specialty care.

Methods: Participants (N = 248) were from New Journeys, a network of coordinated specialty care programs in Washington State. Recent (i.

Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes.

Background: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use disorder (MOUD; e.

Yakima County Incidence Rates of Sexually Transmitted Infections From 2013 to 2018 in Urban-Rural and Area-Deprivation Continua.

Background: This study aimed to examine variations in the incidence rates of sexually transmitted infections (STIs; i.e., chlamydia, gonorrhea, and syphilis) across the urban-rural and area-deprivation continua from January of 2013 to December of 2018 in Yakima County, Washington.

Taking a Look at How Family Member Engagement Influences Service User Engagement in New Journeys: a Coordinated Specialty Care Program.

Family members are integral to the care and support of individuals experiencing early psychosis, and while studies have brought to light the impact of family engagement, there is a dearth in the literature on the ways family engagement in services affects service user engagement. The present study examined the relationship between initial family engagement and service user engagement among 349 service users enrolled in New Journeys, a network of coordinated specialty care (CSC) programs. Service users whose family members were initially engaged in treatment in the first month were more likely to remain engaged and attend appointments during the first 7 months relative to service users whose family members were not initially engaged (χ=88.

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study.

This study aimed to explore clinician roles and experiences related to the implementation and sustainability of coordinated specialty care (CSC) programs for first episode psychosis. Qualitative interviews were conducted with 20 CSC providers and team members, recruited from five CSC programs. Using a semi-structured guide, interviews explored experiences with the delivery of CSC in the context of community-based outpatient mental health agencies and the challenges with implementation.

Systematic review of pathways to care in the U.S. for Black individuals with early psychosis.

The pathway to receiving specialty care for first episode psychosis (FEP) among Black youth in the US has received little attention despite documented challenges that negatively impact engagement in care and clinical outcomes. We conducted a systematic review of US-based research, reporting findings related to the pathway experiences of Black individuals with FEP and their family members. A systematic search of PubMed, PsycInfo, and Embase/Medline was performed with no date restrictions up to April 2021.

The unique pathways to coordinate specialty care for Black families navigating early psychosis: A preliminary report.

Background: Aversive pathways to coordinated specialty care (CSC) for first episode psychosis have been linked to the extended duration of untreated psychosis, limited engagement, and treatment outcomes. Yet there has been very limited research that has solely explored the unique pathways to care among Black families in the U.S.

Onset of alcohol use disorder among alcohol initiates by race/ethnicity.

Prevalence of alcohol use disorders (AUD) varies across racial/ethnic groups. It remains unclear whether rapid transition from first-time alcohol use to developing AUD varies by race and ethnicity. In this study, we investigate racial/ethnic differences in AUD onset among first-time alcohol drinkers and identify specific predictors of AUD onset by racial/ethnic group.

Drug and alcohol treatment utilization and barriers among Black, American Indian/Alaskan Native, Latine, Asian/Pacific Islander/Native Hawaiian, and White adults: Findings from NESARC-III.

Background: Existing epidemiological data suggest differences across racial/ethnic groups in drug and alcohol treatment utilization and barriers to treatment and typically include only Black, Latine, and White adults. The objective of this study was to examine whether disparities remain for DSM-5 lifetime alcohol use disorder (AUD) and drug use disorder (DUD) treatment utilization and barriers across Black, American Indian/Alaska Native (AI/AN), Latine, Asian/Pacific Islander/Native Hawaiian (Asian/PI/NH), and White adults.

Methods: The current study conducted secondary analyses on data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III).

Geographic Disparities in Access to Specialty Care Programs for Early Psychosis in Washington State.

Supported by the 10% set-aside funds in the Community Mental Health Block grant, distributed at the state level, coordinated specialty care (CSC) have been widely disseminated throughout the U.S. This study explores variations in the geographical accessibility of CSC programs by neighborhood level characteristics in Washington State.