Jennifer Humensky1,2, Lisa Dixon1,2; 1Columbia University, 2New York State Psychiatric Institute
Introduction: Onset of psychosis occurs most commonly at ages 15-25, the ages at which young people are developing adult identities – education, employment and career development are crucial in this process. Coordinated specialty care (CSC) programs provide coordinated access to team based early invention services for psychosis, including supported education and employment (SEE) services. This study prospectively evaluated education and employment outcomes over time within New York State’s CSC program, OnTrackNY. Methods: Assessment data are collected by clinical staff at admission, quarterly, and at discharge. Trajectories of education and employment status are assessed using generalized estimating (population averaged) models with an autoregressive covariance structure to account for within-subject correlations over time. Participants (n=779) were enrolled in OnTrackNY from October 2013 to September 2017. Results: 41% (SD 49%) were in school/work at baseline, rising to 62% (SD 48%) at 3 months, and 75% (SD 43%) at 12 months. Work/school participation at baseline was the strongest predictor of subsequent work/school participation (OR=24.8 [95% CI: 16.4-37.7], as were higher GAF symptom scores (less severe symptoms) (OR=1.01 [1.00-1.02]) and longer time in program, (OR=1.34 [1.27-1.42]. Older participants had lower odds of work/school participation (OR=0.93 [0.88-0.98]), as did males relative to females (OR=0.70 [0.49-0.99]), Hispanics compared to non-Hispanic whites (OR=0.66 [0.45-0.98], and those with high school/GED compared to those with less than high school (OR=0.48 [0.31-0.75]). Conclusion: CSC participants achieve significant improvements in education and employment. CSC teams should support vocational efforts, particularly among those at risk of poor performance, to help participants achieve their goals.
