F116. HELP-SEEKING BARRIERS FOR YOUTH AT CLINICAL HIGH RISK OF DEVELOPING PSYCHOSIS: BY DEMOGRAPHIC INFORMATION

Abstract

Background: Much attention has been given to pathways and barriers to care for early and first episode psychosis in order to inform early intervention. Early intervention is crucial for reducing negative prognostic outcomes such as those associated with long duration of untreated psychosis (DUP). Help-seeking and pathways to care for individuals at “clinical high-risk for psychosis” (CHR) are thus important processes to understand. Intervention during the CHR phase may reduce the development of psychosis and negative outcomes associated long DUP. Even for CHR individuals who do not go on to develop psychosis, a significant proportion of these individuals continue to experience adverse mental health and functioning outcomes that can be addressed by early intervention and referral. A sociodemographic examination of barriers to care is pertinent to reducing mental health care disparities for marginalized and disenfranchised groups such as racial/ethnic minorities in the US and those with low socioeconomic status. Extant literature has also found differential help-seeking by gender. Little is known about barriers to care for CHR individuals by pertinent socio-demographics. Methods: Baseline data were reported from 181 CHR participants as a part of a longitudinal study of psychosis risk (PR) individuals from November 2012 to December 2015 at Beth Israel Deaconess Medical Center/Harvard Medical School (Boston, MA), Maine Medical Center (Portland, ME), and the New York State Psychiatric Institute (New York, NY). CHR participants were assessed by clinician interview and self-report questionnaires. The help-seeking barriers measure is a 20 item self-report measure where participants were asked to rate (1 = not true at all-4 = very true) the extent to which specific statements were challenges that affected whether they sought care. CHR participants were predominately male (n = 133; 73%; 2 did not report gender) and were mostly White/European (n = 113; 62%) with about one third from US racial and ethnic minority backgrounds (n = 60; 33%; 8 did not report race/ethnicity). Results: The help-seeking barriers measure demonstrated good reliability in this sample (α = 0.8). Female CHR participants endorsed significantly more helpseeking barriers (M=87.11) compared to male CHR participants (M=72.1) (U = 2311, p = 0.04). There were also trends that non-European CHR participants (M=83.8) reported higher levels of barriers than their white counterparts (M73.9), and CHR individuals from lowest social economic status had highest level of barriers (Low SES=47.6, Middle SES=43.9, High SES=42.3). Discussion: Demographic information may contribute to timely help-seeking behaviors. Female, non-white, and lower SES CHR participants seem to experience more barriers to mental health help-seeking compared to male, white, and high SES CHR participants. While increased outreach for early intervention and engagement in services is overall crucial, knowledge about the extent to which barriers are perceived by pertinent socio-demographics is important for reducing mental health care disparities.