Demographic and Socioenvironmental Profile of Latine Service Users in the National Early Psychosis Intervention Network (EPINET)

Background and Purpose

The U.S. Latine population is the fastest growing ethnoracial category in the country, yet not enough information is available about this group within the scope of early psychosis services. There is some evidence of disparities related to access to care, pathways to care, and service use for Latines experiencing recent-onset psychosis. Important cultural and socioenvironmental factors have been shown to be important in the pathways to mental health care, engagement with services, and outcomes. The national Early Psychosis Intervention Network (EPINET) presents a unique opportunity to consider the diversity within Latines as it relates to service outcomes. This study aims to examine the demographic, cultural, and socioenvironmental characteristics of Latines entering the EPINET network and how they compare with non-Latine white service users.

Methods

The EPINET National Data Coordinating Center harmonizes and aggregates data collected as part of treatment in EPINET clinics from eight regional hubs across the US. The current study is an analysis of the national EPINET data and includes the baseline data of 987 Latine service users and 1527 non-Latine white individuals. Analyses included descriptives, t-tests, chi squared, and regression analyses controlling for age and hub. Outcomes evaluated between the ethnic groups include duration of psychosis before entering CSC program, primary diagnosis, housing circumstances, health insurance type, referral source, legal issues, mental health hospitalization, use of crisis services, suicide attempts, and self-injurious behavior.

Results

Latines in early psychosis programs were slightly younger in years (M=20.63) than their NL white peers (M=22.14) but had a shorter time in months (M=11.61) between onset of psychotic symptoms and enrollment in an EPINET program compared to NL whites (M=15.83; all t-tests p<.001). Latines were concentrated in hubs based in California (14.5%), Texas (13.8%), New York (32.4%), and one representing multiple states including Florida (16.4%). The majority of white individuals had commercial insurance (61.5%) whereas a majority of Latines had Medicaid (61.3%). In terms of housing, 90.6% of Latines lived with family compared to 79.4% of whites. The top referral sources for both groups were inpatient mental health and outpatient mental health settings. Latines were more likely than their white peers to have had encounters with a crisis stabilization unit (OR=3.26, p<.001) prior to program intake but less likely to report self-injurious behavior (OR=.67, p>.05).

Conclusions and Implications

Building information on a robust ethnoracial subpopulation of individuals experiencing early psychosis is crucial to providing equitable evidence-based care. Results were in line with limited research on mental health service disparities that Latines experience. Both strengths (high percentage of Latines living with family, living in ethnically-dense areas) and challenges were identified in the current analysis. Social workers can play a crucial role in ensuring early psychosis services are culturally responsive and structural barriers to care are minimized.