An Exploratory Inductive Thematic Analysis of Focus Groups with Spanish-Speaking Clinicians in Clinical High Risk and Early Psychosis Services in Massachusetts
Melanie Maldonado, Olivia Helfrich-Tapia(a,b), Joey Rodriguez(a,b) Michelle Friedman-Yakoobian(a,b), Bernalyn Ruiz-Yu(a,b,c)
a. Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston MA
b. Department of Psychiatry, Harvard Medical School, Boston MA
c. Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston MA
Background: State-wide initiatives are enhancing the growing recognized need for early intervention for youth at clinical high risk for psychosis (CHR-p) in Massachusetts. If state-wide program development for early psychosis treatment is to be as equitable as it is effective, then it must strategically address the specific needs of non-English-speaking communities. The Spanish Advisory Board for Linguistic Development (SALUD) was established to identify strategies to support the development of specialized early psychosis treatment teams in alignment with state-wide strategic priorities.
Methods: Ten CHRp service providers participated in five biweekly virtual focus groups that were held to conduct a needs assessment for quality of care, satisfaction and engagement, and service delivery for Spanish-speaking youth and families. Participants were all Spanish-speaking staff, 60% (n=6), in clinical and 40% (n=4) in non-clinical roles. From this group, 20% (n=2) identified as Puerto Rican, 10% (n=1) as Cuban, 10% (n=1) Chilean, 10% (n=1) Ecuadorian, 10% (n=1) Haitian, 10% (n=1) Peruvian, 10% (n=1) Mexican, and 30% (n=3) did not specify. Next, transcripts of each focus group were analyzed via an exploratory inductive thematic analysis.
Results: Six main themes were identified. Participants identified (1) time restraints and staff/structural challenges, (2) billing limitations and system limitations (3) need for language diversity, (4) cultural awareness, (e) psychosis education, and (f) outreach.
Conclusion: Services offered for CHRp must be improved to appropriately consider the cultural and language backgrounds of Spanish-speaking clients. As reported by Spanish-speaking clinicians, services should be expanded to include the diverse Spanish languages of communities as well as assessment tools and psychoeducation.