Development of a Community-Based Public Health Approach to Preventing Psychosis among Youth at Clinical High-Risk
Poster C97, Wednesday, October%2010, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom
Peter Bachman1, Diana Mermon1, Miranda Bridgwater1, Nicholas Theis1, Abigail Schlesinger1,2; 1University of Pittsburgh Department of Psychiatry, 2Children's Hospital of Pittsburgh of UPMC
Although the value of interventions designed to prevent psychotic disorders is increasingly appreciated by academic psychiatry, substantive questions remain regarding how to best implement early detection and intervention in the world beyond the university medical center. HOPE TEAM (Help Overcoming Prodromal Experiences Through Early Assessment and Management) was developed to deliver early detection of, and intervention for subthreshold psychosis to youth (ages 10-26 years) in Allegheny County, Pennsylvania, USA. Using data on community-level deprivation, we identified neighborhoods with high levels of psychosis risk factors, including racial or ethnic minority status, history of trauma, exposure to violent crime, urban setting, and poverty. We then partnered with an existing social service agency, Family Care Connection, which has offices in, and a record of decades of service to these neighborhoods, to accelerate HOPE TEAM’s integration and acceptance into the local community. The first set of 50 referrals demonstrate that we succeeded in recruiting individuals for assessment and intervention who would not have presented for services at the university medical center. Compared to a medical center-ascertained sample, young people who were referred to HOPE TEAM tend to live close to the clinic (<1.2 mi), and they report higher levels of early life and current adversity (including trauma), as well as lower socio-economic status (all p’s<0.05). They are also more likely to identify as racial minorities (p<0.05). Taking this data-driven, community-based approach allows us to work with a population that is highly enriched for psychosis risk, who would not otherwise be visible to clinical investigators.
Topic Area: Service System Development and Reform