Session: From Onset to Early Intervention Services: Social Work Research on First-Episode Psychosis (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Session Introduction: Psychosis can have profound negative impacts on clients, their families, and society at large.  It is a costly and disabling mental health condition worldwide.  The period between the onset of first psychotic symptoms and entry into early intervention services, also known as the duration of untreated psychosis (DUP), is a critical concern for the mental health system. Two influential meta-analyses revealed that the global average of DUP was approximately 2 years, falling short of the 3 month goal set by the World Health Organization.  Studies show that longer DUP is associated with a constellation of negative outcomes, including negative treatment response, worse global, vocational, social, and cognitive functioning, greater positive and negative symptom severity, higher risk of relapse, and lower quality of life, resulting in unnecessary pain and suffering to clients and their families.  Efforts to identify and treat people with first episode psychosis through specialized early intervention services (EIS) can result in significant reductions in morbidity, disability, and better quality of life.   

 In this symposium, we bring together the work of three social work scholars focusing on understanding and reducing DUP and improving the lives of clients and families experiencing first episode psychosis through early intervention services (EIS).  Paper #1 will present the results of a qualitative study that used retrospective semi-structured qualitative interviews with clients recovering from their first episode of psychosis and their family members to characterize their pathways to care from the onset of their first episode to their entry into early intervention services in New York City. This examination uncovered serious gaps and bottlenecks in the pathway to care that contributed to DUP highlighting important areas for potential interventions to reduce DUP.  Paper #2 will present results from a survey study that examined the perceptions of social workers serving adolescents and young adults in Maryland for developing a training program to identify first episode psychosis in community settings.  The results of this study indicate that training social workers to identify youth with first episode psychosis and to make appropriate and valid referrals to specialty clinics may be an effective approach to reduce DUP in the United States.  Paper #3 will describe the OnTrackNY model, an innovative coordinated specialty care program for clients with recent onset of psychotic symptoms, and present demographic, clinical, functioning and service use data of 298 currently enrolled clients. The results of this study indicate that young people with recent onset of psychotic disorders who receive OnTrackNY service can engage in work and school and achieve higher clinical, social and occupational functioning.   

Together the papers in this symposium illustrate a variety of methodological approaches that can be used to study first-episode psychosis and early intervention services. The discussant is a senior and leading expert in the field of first-episode psychosis and will draw together commonalities and differences between the three presentations detailing implications for future research and social work practice.