An Exploration of Disparities in Telemedicine in Early Intervention Services

Samantha LaMartine PsyD (1,2), Beshaun Davis, PhD (3), Rachel Oblath PhD (1,2), Daisy Perez MPH (1,2), Luisa Camacho MPH (2), Hannah E.Brown MD (1,2), Emily Kline, PhD (1,2)

1. Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
2. Wellness & Recovery After Psychosis Program, Boston Medical Center, Boston, MA
3. Department of Psychiatry, University of Maryland School of Medicine, College Park, MD

Abstract

Background: In the early stages of psychotic disorders, limited self-awareness often leads to poor treatment adherence, more hospitalizations, and increased symptom severity. While coordinated specialty care has proven effective, it usually requires in-person sessions . Although the COVID-19 pandemic created an environment where telemedicine became an accepted alternative, its effectiveness in treating early stages of psychosis is not yet well-studied. This is a significant gap, as those who are newly diagnosed have distinct needs and may be ambivalent about receiving care. Furthermore, unequal access to technology could potentially make telemedicine less effective . These concerns are especially relevant for minoritized populations, who are more likely to be diagnosed with severe mental illness, more prone to slide into poverty following the diagnosis and experience higher dropout rates from in-person care. This study aims to address the existing gaps in understanding the feasibility and effectiveness of telemedicine as a treatment approach for early psychosis among Latinx and Black individuals.
Methods: This study will use Consensual Qualitative Research to allow data-driven categories to emerge. Researchers will recruit 10-15 Black or Latinx adults to share their telemedicine experiences. Multiple judges will analyze the interviews to reach a consensus on the data interpretation, and an auditor will counteract groupthink. The findings will be organized into themes.
Results: Recruitment for this study is ongoing. Preliminary data will present quotes and initial themes from interviews conducted to date, focusing on patient preferences for telehealth versus traditional therapy and potential barriers to utilizing telehealth services.
Conclusions: Depending on the outcomes, the study could offer valuable insights for improving care and engagement in this vulnerable population. Future steps may include optimizing telemedicine platforms to cater to these specific needs and addressing technological barriers to access.