Methods: Data was collected as part of a developmental trial examining the feasibility of a multi-component psychosocial intervention for low-income YYAs with mental health conditions between the years 2015-2017 (Munson et al., 2016). Fifty-eight participants were recruited, between the ages 16-20, and receiving services for a mental health disorder at a community-based outpatient clinic. Youth that reported psychotic experiences answered the following questions: 1) How did you and those who lived with you deal with you experiencing psychosis? and 2) How have you and your team of supports dealt with psychosis? Applying thematic analysis techniques, two analysts independently went through the responses and identified themes. Authors sought out to corroborate those youth that reported experiencing psychosis with CSI psychosis items, a self-report measure of psychiatric symptomatology. Finally, a t-test compared means on the CSI between those that reported psychosis with those that did not.
Results: Sample characteristics include mean age 17.8 (1.1), 63% female, 34% White, 20% Black, 14% Latino, 19% Biracial, 7% Asian, 4% Middle Eastern, and 2% Other. Seventy% of the YYAs were on Medicaid and all others deemed low-income by Clinic Director, 14% in child welfare, and 19% in special education. Twenty-nine% of the youth reported experiencing psychosis. Interestingly, 59% of the youth reported psychosis items on the CSI but did not report experiencing psychosis. There was a significant difference in the CSI scores for YYAs reporting experiencing psychosis (M=24.8, SD=8) and those YYAs that did not report experiencing psychosis (M=17.22, SD=8.6); t (55) = -.3, p = 0.003. Common themes that emerged from the qualitative data included youth reporting lack or delayed disclosure, “nobody knew, but me. I basically ignored it”, negative emotions (e.g. scared, shame), negative messages from people in their lives, “mom would not pay no mind to it, say I was stupid, you’re buggin out”, and coping mechanisms that ranged from avoidance, music, breathing techniques, discussion with their providers, and medication.
Conclusions and implications: This study emphasizes the importance of having multiple methods to identify YYAs that may be experiencing psychosis. It also suggests the need for more training on both referral and treatment for psychosis in community-based settings.