Intersecting disadvantage: Unpacking poor outcomes within early intervention in psychosis services
| Autor: | Anthony Vasquez, Al Gilbert, Zhen Zhao, Larry Davidson, Nev Jones, Julia Godzikovskaya |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Mental Health Services Family support 03 medical and health sciences 0302 clinical medicine Risk Factors Early Medical Intervention medicine Ethnicity Humans Biological Psychiatry Disadvantage Aggression Patient Discharge 030227 psychiatry Early intervention in psychosis Disadvantaged Psychiatry and Mental health Treatment Outcome Psychotic Disorders Socioeconomic Factors Preparedness Female Pshychiatric Mental Health Thematic analysis medicine.symptom Psychology Psychosocial 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Early intervention in psychiatry. 13(3) |
| ISSN: | 1751-7893 |
| Popis: | Aim In order to strengthen specialized early intervention in psychosis (EIP) services, a contextually nuanced understanding of psychosocial forces driving suboptimal treatment response is critical. This study sought to examine factors driving poor outcomes through a systematic emic coding of psychosocial assessments for discharged EIP clients categorized as leaving with all treatment goals met (AG) or no treatment goals met (NG). Methods Psychosocial assessments at baseline, 1 year, 2 years and discharge were extracted from an EIP research registry and systematically coded. One hundred and thirty clients met the study's inclusion criteria (72 NG, 58 AG) from a larger pool of 278. Assessments were coded, quantized and analysed using a combination of basic inferential statistics and thematic analysis. Results Structural adversity, individual trauma, history of aggression/violence, limited insight and long treatment histories prior to EIP, were strong and significant predictors of poor client outcomes (NG), while motivation for treatment, college goals or preparedness at baseline, baseline engagement in constructive activities, social strengths, individual strengths, talents and family support strongly predicted better outcomes (AG). Race/ethnicity also significantly predicted outcome group. Analyses underscore the powerful impact of multiple converging forms of structural disadvantage, on the one hand, and individual, family and social strengths and supports on the other, in shaping clients’ response to EIP treatment. Conclusions Findings emphasize the importance of greater empirical attention to background structural and socio-economic conditions among early psychosis clients and their multifaceted impacts and underscore the potential value of programmatic components explicitly designed to support clients from multiply disadvantaged backgrounds. |
| Databáze: | OpenAIRE |
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