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Black Youth Experience Disparities in Care for First-Episode Psychosis in Ohio

Black Youth Experience Disparities in Care for First-Episode Psychosis in Ohio 1024 683 Jessica Nye, PhD

Black youth enrolled in Medicaid were more likely to experience a first-episode psychosis (FEP) event and be diagnosed with schizophrenia spectrum disorder but less likely to receive key early intervention services than White youth.

 

“It’s been known for a long time, especially in the United States, that Black individuals specifically face racial disparities when it comes to psychosis — in terms of diagnosis, but also in terms of treatment,” says Aubrey M. Moe, PhD, an assistant professor at The Ohio State University and primary author of a study published in Schizophrenia Bulletin Open. “There’s been a lot of emphasis in the last 20 years on intervening earlier in psychosis, because we know the earlier we can give people specialized services, the better they do.”

Dr. Moe and colleagues in the Center for Suicide Prevention and Research at Nationwide Children’s Hospital conducted this retrospective longitudinal cohort using data from Ohio Medicaid. Youth (n=987,982) with continuous enrolment for 365 days or longer between 2010 and 2020 were evaluated for FEP, schizophrenia spectrum disorder and health care utilization.

The study population comprised 56.4% girls and women, 78.0% were aged 15 to 19 years and 26.4% were Black.

Compared with White youth, Black youth were more likely to experience an FEP event in the first 365 days of Medicaid enrollment (adjusted odds ratio [aOR], 1.11).

Within a year of the FEP event, Black youth were more likely to be diagnosed with schizophrenia spectrum disorder (aOR, 1.81) and were less likely to receive any psychotherapy (aOR, 0.78), which is a key part of early intervention services for early psychosis.

“We have this story emerging where these young people are being diagnosed more often than their non-Hispanic, White peers, and at the same time, they’re less likely to access care,” says Dr. Moe.

In the future, the investigators have plans to expand their research about disparities in FEP.

Cynthia A. Fontanella, PhD, principal investigator in the Center for Suicide Prevention and Research at Nationwide Children’s concludes, “We need to do this kind of research on a national level. We need to look at: Why are these kids getting diagnosed more? Is there bias? And we need to delve into what to do about it. We don’t know what is effective in reducing these disparities. […] We need to address some of these issues by making services more culturally [tailored] and by increasing the diversity in our providers.”

 

 

Reference:

Moe AM, Llamocca E, Wastler HM, Steelesmith DL, Brock G, Oluwoye O, Fontanella CA. Racial and Ethnic Disparities in the Diagnosis and Early Treatment of First-Episode Psychosis. Schizophr Bull Open. 2024;5(1):sgae019.

Image credit: Adobe Stock

About the author

Jessica Nye, PhD, is a freelance science and medical writer based in Barcelona, Spain. She completed her BS in biology and chemistry and MS in evolutionary biology at Florida State University. Dr. Nye studied population genetics for her doctorate in biomedicine at University of Pompeu Fabra. She conducted her postdoctoral research on the inheritance of complex traits at the Autonomous University of Barcelona.

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