Sexual and Gender Minority Reporting in First-Episode Psychosis Outpatient Care

Jacqueline F. Dow, MPH (1) , Tamara Welikson, PhD (2,3), Tithi Baul, MPH (4,5), Kelsey A. Johnson, MPH (6), Hannah Brown, MD (4,5), Dost Öngür, MD, PhD (1,3), Brittany Gouse, MD, MPH (4,5)

1. Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA
2. Psychotic Disorders Division, McLean Hospital, 115 Mill Street, Belmont, MA
3. Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA
4. Department of Psychiatry, Chobianian and Avdesian School of Medicine at Boston University
5. Wellness and Recovery After Psychosis Research Program, Boston Medical Center, Boston, MA
6. Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA

Abstract

Background: Sexual and/or gender minorities (SGM) have increased rates of social adversities and adverse mental health outcomes such as suicide. To our knowledge, there is a paucity of prior work describing the SGM population engaged in first episode psychosis (FEP) care. Here, we aim to describe the proportion of FEP clients in Massachusetts who self-identify as a member of an SGM group.
Methods: We performed a cross-sectional analysis of baseline demographic data collected 3/2016-11/2022 through the MAPNET/EPINET core assessment battery (CAB) from 11 FEP clinics in Massachusetts. Gender identity and sexual orientation were self-reported, and sex assigned at birth was either self-reported or collected through chart review. These sexual orientation/gender identity (SOGI) data were analyzed using descriptive statistics.
Results: In this cohort of 750 young adults (mean age of 23.6), 16 individuals identified as a gender minority (2.14%), 14 individuals identified as non-binary (1.87%), and 2 individuals identified as another gender (0.27%). Additionally, 25 individuals identified as a sexual minority (3.3%), 7 individuals identified as gay/lesbian (0.93%), 16 individuals identified as bisexual (2.1%), and 2 individuals identified as another sexual orientation (0.27%). Further analyses will evaluate the missingness of these data.
Conclusions: The proportion of clients captured through the current MAPNET/EPINET CAB identifying as a member of an SGM group is lower than what has previously been reported in population-based studies. Further work is needed to understand if this assessment is underrepresenting this population. Improvements to the collection of SOGI measures are imperative in understanding the need for SGM-affirmative support in FEP settings. Our next step is to describe the proportion of sites capturing SOGI data over time given the lack of standardization in timing of collection of this variable across FEP programs.