Jennifer Humensky1,2, Lisa Dixon1,2; 1Columbia University, 2New York State Psychiatric Institute
Background: Early intervention services provide access to coordinated services for young people with early psychosis. A key component is access to supported education and employment (SEE) services, which are generally not available in standard outpatient mental health treatment. Previous studies have shown that employment is a primary goal for young people in early psychosis treatment and, in qualitative interviews, participants stated that access to SEE services is a key motivator for program engagement. We examine predictors of SEE use and whether SEE use was associated with greater use of OnTrackNY services in subsequent time periods. Methods: OnTrackNY serves individuals ages 16-30 who are within two years of a first episode of psychosis. Assessment and service utilization data are collected at admission, quarterly, and discharge (n=779). Analyses utilized generalized estimating equations (population averaged models). Results: Predictors of using the SEE specialist included having lower work/school participation at admission (OR: 0.62 [95% CI: 0.44-0.87]), younger age (OR: 0.91 [95% CI: 0.86-0.97]), and not being prescribed antipsychotic medication (OR: 0.59 [95% CI: 0.40-0.87]). Use of the SEE specialist was associated with higher odds of engaging any team members in the subsequent period (OR:8.77 [95% CI: 1.76-43.58]); visits with no other team member were significantly associated with probability of subsequent engagement. Models control for time in program, program site, gender, age, race/ethnicity, educational attainment, education/employment participation and symptoms at admission, duration of untreated psychosis, substance use and medication adherence. Conclusion: Access to SEE specialists is an important lever for engagement in early psychosis treatment.
