Family Involvement in First-Episode Psychosis Treatment of Sexual and Gender Minority Patients
Nicole Cerundolo (1) and Vivian Nye (1), Jacqueline Dow (1), Alyssa Williamson (2), Kelsey Johnson (2), Emily Carol (1, 3), Dost Öngür (1, 3)
1. Division of Psychotic Disorders, The LEAP Center, McLean Hospital
2. Massachusetts Psychosis Network for Early Treatment (MAPNET), Beth Israel Deaconess Medical Center
3. Department of Psychiatry, Harvard Medical School
Abstract
Background: Family involvement in first-episode psychosis (FEP) treatment is associated with improved mental health outcomes (e.g., lower relapse rates and better treatment adherence). The onset of psychosis typically occurs in late adolescence or early adulthood, when many individuals are still reliant on their families for housing and financial support. Sexual and gender minority (SGM) youth report lower levels of parental support and worse mental health outcomes than their non-SGM peers, but family involvement in FEP treatment has not been studied in SGM patients. Given this disparity, we hypothesized that SGM patients would report significantly lower rates of family involvement.
Methods: We conducted a secondary analysis of data collected for quality improvement across several coordinated specialty care (CSC) clinics in Massachusetts. The sample included N=430 FEP patients (SGM-identifying = 4.9%, mean age = 23). Survey questions assessed self-reported demographic information, past family involvement in care (operationalized as yes/no), and preference for family involvement (restricted/unrestricted/none). Patients identifying as non-cisgender and/or non-heterosexual in the demographics questionnaire comprised our SGM subsample. Data were drawn from patients’ most recent reports with complete responses regarding family involvement.
Results: A chi-squared test of independence indicated that family involvement in care is significantly lower in SGM patients, X² (1, N = 430) = 39, p < .001. Additionally, we provide descriptive statistics summarizing SGM and non-SGM patients’ preference for family involvement in care.
Conclusions: In our sample, SGM patients reported less family involvement in care than non-SGM patients. This preliminary analysis highlights a need for further research into the relationships between SGM identity, psychosis, and family involvement in care. Such research could elucidate how CSC can be tailored to meet the unique clinical needs of SGM patients and their families.