178. Practical Strategies to Reduce the Duration of Untreated Psychosis in the United States: Early Findings

Abstract

Overall Abstract: The World Health Organization recommends that treat-ment for psychosis begin within 3 months of symptom onset. However, more than two dozen studies worldwide have observed an average delay of 2 years between the appearance of psychotic symptoms and treatment initiation. Two infuential meta-analyses, as well as the Recovery After an Initial Schizophrenia Episode-Early Treatment Program trial in the United States, clearly establish that the duration of untreated psychosis (DUP)-time from psychosis onset to treatment initiation-is correlated with poor clinical outcomes. In the United States, DUP is typically 1-3 years, suggesting that many people with frst-episode psychosis (FEP) miss a critical opportunity to beneft from early intervention, despite the increasing availability of FEP programs in the United States. Accordingly, the National Institute of Mental Health (NIMH) initiated a research program to develop and test practical strategies for reducing DUP in the U.S. This symposium presents preliminary fndings from four of these NIMH studies and discusses implications for reducing DUP both in the United States and internationally. Lisa Dixon will present fndings from a qualitative study to identify the sources of help-seeking delays among persons receiving FEP care: help seekers' ability to identify psychotic symptoms, stigma around care, and self-reliance contributed to delays, and health care contacts represented critical junctures that could expedite or delay care. John Kane will present fndings from a series of experiments designed to increase psychosis awareness, identify individuals with FEP and connect those individuals to FEP care by leveraging the enormous reach of the internet and social media. Vinod Srihari will present preliminary fndings from a large-scale trial of Mindmap-a population-based, multi-element approach to reducing DUP-demonstrating encouraging changes in pathways to FEP care and consistent trends in reduction of DUP. Steven Lopez will present fndings on psychosis literacy and help-seeking attitudes among US Latinos with FEP, their family members, and community residents. Discussant Rachel Loewy will consider the implications of these fnd-ings for developing practical DUP reduction strategies in the U.S. and internationally.