Gaps in Clinical Access for Individuals with a New Onset Psychotic Disorder: A Spatial Analysis

Shruti Bahukudumbi, Kelsey Johnson (MPH)

Abstract

Background: First episode psychosis (FEP), or the first time a person experiences a psychotic disorder, is a debilitating condition for which early intervention improves longer-term outcomes. Intervention within the first 2 to 5 years can limit the negative effects of psychotic symptoms, lower the risk of relapse, preserve psychosocial skills and facilitate a rapid recovery. 1,2 Many individuals face challenges in accessing psychosis specialty clinics and other mental health services because of out-of-pocket costs, transportation difficulties, lack of appointment availability, disparities in access to care, and social stigma. 3,4 This project utilizes data from the Massachusetts Psychosis Network for Early Treatment (MAPNET) program at Beth Israel Deaconess Medical Center to identify the extent of reach of psychosis specialty programs in Massachusetts. This study aims to (A) Identify the proximity of patients with new onset psychotic disorders to existing psychosis specialty clinics in order to locate gaps in treatment provision and (B) Identify the socio-economic breakdown of patients with new onset psychotic disorders to identify potential demographics that are being systematically under- served.

Methods: Deidentified data obtained was from 2016-2021, primarily from MASS.GOV, CENSUS tracts, and the MAPNET database. All categories were converted from point to vector data. Tabular data was geocoded using Zip Codes and XY coordinates. Dot-density maps were created to visualize the spatial spread of exist- ing psychosis-specialty programs in proximity with the population distribution in Massachusetts. Further maps are being created to depict the drive-time to psychosis-specialty programs, and locations of upcoming clinics.