Leslie Marino1,2, Melanie Wall1,2, Jennifer Scodes1,2, Hong Ngo1,2, Ilana Nossel1,2, Iruma Bello1,2, Thomas Smith1,2, Lisa Dixon1,2; 1Columbia University Medical Center, 2New York State Psychiatric Institute
PURPOSE: Substantial research has demonstrated that a longer duration of untreated psychosis (DUP) is associated with poorer outcomes among young adults with early non-affective psychosis. As federal funding has expanded access to evidence-based coordinated specialty care (CSC) in the US, little is known about factors influencing the pathway to care and DUP in non-research treatment settings. This study explores the pathway to care and predictors of time to OnTrackNY, New York state’s CSC program. METHODS: The sample includes 779 individuals ages 16-30 within two years of onset of non-affective psychosis enrolled in OnTrackNY at 19 sites as of September 2017. Multivariate analyses tested the association between the primary outcome of time from onset of psychosis to intervention (OnTrackNY) and a comprehensive list of predictors within the admission assessment domains of demographic and clinical characteristics; social and occupational functioning; suicidality/violence/legal problems; service utilization; family characteristics; and prior mental health contacts. RESULTS: The mean time to treatment was 231.18 days (SD=187.66) with a median of 169 days (5.63 months). In multivariate analyses, current school participation (p=.005) and at least one psychiatric hospitalization (p<.001) were associated with shorter time to intervention, whereas when first service contact is hospitalization (p=.006) or an outpatient visit (p<.001), compared to ER visit, time to intervention is longer. CONCLUSIONS: Engagement in school and the early mental health service contacts can predict the pathway to care and time to early intervention services in a cohort of young adults with early psychosis. This has implications for efforts to reduce DUP.
