Psychosis Risk Screening Attitudes and Practices in College Mental Health Centers

Harini Suresh M.D. , James Green B.A., Isabela Pena, Colette Potts Ed.M., Michelle Friedman-Yakoobian Ph.D.

Beth Israel Deaconess Medical Center, Response to Risk Research

Abstract

Background: The onset of psychotic disorders occurs most commonly in late adolescence/early adulthood. Routine screenings by college mental health clinicians and increased familiarity with identifying symptoms of psychosis may lead to earlier intervention and therefore improved treatment outcomes.
Methods: Participants included college-affiliated mental health clinicians in Massachusetts. Prior to virtual conference attendance on 11/9/2022, they completed a pre-survey assessing confidence and familiarity with psychosis screening tools, identification of symptoms, and community referrals – all topics included in the subsequent training. Clinicians completed a post-survey in 2/2023. Pearson correlations assessed associations between variables in baseline, and paired samples t-tests analyzed whether familiarity, confidence, and number of students with full psychosis or risk for psychosis screened significantly improved 3 months after training.
Results: Forty-eight clinicians completed the pre-intervention survey, of which 29% identified as counselors, 25% as psychologists, and 25% as social workers. Private university clinicians made up 75% of the cohort. Mean years in practice was 3-5 years. Participants were more likely to screen for other mental health concerns (85%) than psychosis (42%). Overall familiarity with psychosis significantly increased for the 25 participants who responded to the follow-up survey (t(24) = 4.51, p < 0.001, d = 0.9), with a large effect size (d = 0.9) associated with timepoints. Confidence in providing care for individuals with psychosis did not significantly increase at three-month follow-up (t(24) = 0.29, p = 0.77).
Conclusions: Our results suggest that delivery of this educational intervention for college mental health clinicians may lead to improved familiarity with psychosis. Higher familiarity was associated with more routine clinical screening of students for psychosis/psychosis risk. New resources for referral for youth at-risk or experiencing psychosis may help increase clinician confidence (e.g., MPATH). Other limitations include a lack of control group, clinician drop-out rate (from pre- to post- intervention), and self-reporting bias.