Sociodemographic Differences and Engagement in Care among Hispanic Patients Receiving Care for First Episode Psychosis
Alexa M. Rivas (1), Jacqueline Dow (1), Ismael Maganga-Bakita (1), Katerina Konstas (1), Nicole Cerundolo (1), Emily E. Carol (1,2), Dost Öngür (1,2)
Psychotic Disorders Division, McLean Hospital (1), ; Department of Psychiatry, Harvard Medical School (2)
Background: Hispanic individuals experience societal factors that may impact their experiences within the healthcare system, particularly when navigating psychiatric care. These social determinants may interact with the experience of first episode psychosis (FEP) to impact subsequent health outcomes. While existing literature points to decreased health literacy among Hispanics in topics related to psychotic disorders, there is also evidence that Hispanic individuals within the US report higher prevalence of psychotic symptoms than non-Hispanic individuals. Given these intricacies, it is important that ethnic differences in access and outcomes are understood and considered across the psychosis care continuum.
Methods: The present baseline standardized MAPNET/EPINET assessments were collected from N=865 (mean age = 26.78 years) individuals receiving treatment for early psychosis in coordinated specialty care clinics in Massachusetts. Descriptive statistics assess self-reported client ethnicity and its relation to several other variables of interest. Ethnicity was collected as a binary categorical variable coded as Hispanic or Non-Hispanic.
Results: Sociodemographic differences between Hispanic (n=114) and non-Hispanic (n=620) individuals seeking FEP care were present across a number of the variables of interest including insurance, SSI, legal involvement, and housing. Among the sample, 15.53% individuals endorsed Hispanic ethnicity; the 2020 census indicates that Hispanics make up about 18.7% of the Massachusetts population, proposing potentially lower rates of engagement in care among Hispanic individuals. Differences surrounding contact with family and family involvement in care were also present, with 13.3% of Hispanics having reported that their family refused to participate in their treatment, compared to 5.34% of non-Hispanics.
Conclusions: Opportunities exist to increase understanding of differences in social determinants among Hispanic individuals seeking mental health treatment. An improved understanding of the ethnic differences experienced by Hispanics seeking FEP treatment could ultimately enhance care among this population.