The unfulfilled promise of equitable first episode care for Black-Americans: A way forward.
The unfulfilled promise of equitable first episode care for Black-Americans: A way forward.
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DOI：
10.1016/j.schres.2022.01.046
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发表时间：
2022-03
影响因子：
4.5
通讯作者：
Keshavan, Matcheri
中科院分区：
文献类型：
--
作者：
Davis, Beshaun;Anglin, Deidre M.;Oluwoye, Oladunni;Keshavan, Matcheri
协调专科护理（CSC）项目在过去七年中蓬勃发展，并在减少未治疗精神病的持续时间和改善精神和功能结果方面显示出希望（Kane et al., 2015）。然而，尽管未治疗精神病的持续时间与其他人相似，但美国黑人仍然经常在疾病过程中较晚接受治疗（Nagendra et al., 2018），这一事实对最初的参与和随后的结果产生了深远的影响（Oluwoye, Davis, Kuhney, & Anglin, 2022）。目前，这些已知的差异因COVID大流行而加剧，在对患有严重精神疾病的少数种族个体的公平护理方面的差距进一步扩大（Ferrarelli & Keshavan 2020）。一些研究呼吁对初级保健医生进行培训，以识别、监测并将精神病患者转介到CSC项目；然而，到目前为止，还没有研究纳入与美国黑人参与特别相关的因素，如与歧视、种族认同和社区因素有关的因素，如警察监视增加、社区暴力和缺乏资源获取途径（Richman, Kohn-Wood, & Williams, 2007; Wilson et al., 2016）。在过去的50年里，这种差异，特别是与其他种族相比，被诊断患有精神病谱系障碍的黑人美国人的参与率较低，已经得到了很好的记录（Oluwoye等人，2018；Van der even等人，2020）。引人注目的是，在控制了社会经济地位之后，这种差异仍然存在，使这些差异主要是由贫困造成的神话受到质疑。除此之外，一项对最近出院的黑人消费者的研究发现，54.5%的人有三次或更少的门诊心理健康就诊
Coordinated specialty care (CSC) programs have boomed over the past seven years and show promise in reducing the duration of untreated psychosis and improving psychiatric and functional outcomes (Kane et al., 2015). Yet, despite showing similar duration of untreated psychosis as others, Black-Americans still often enter treatment later in the course of illness (Nagendra et al., 2018), a fact that has profound consequences on initial engagement and subsequent outcomes (Oluwoye, Davis, Kuhney, & Anglin, 2022). In present times these known differences have been compounded by the COVID pandemic, where disparities in equitable care for racially minoritized individuals with serious mental illnesses has been further amplified (Ferrarelli & Keshavan 2020). Several studies call for the training of primary care physicians to recognize, monitor, and refer individuals with psychosis to CSC programs; however, no studies to date have incorporated factors particularly relevant for engaging Black-Americans such as those connected to discrimination, racial identity, and neighborhood factors such as increased police surveillance, neighborhood violence, and lack of access to resources (Richman, Kohn-Wood, & Williams, 2007; Wilson et al., 2016).This disparity, specifically lower rates of engagement among Black-Americans diagnosed with psychosis spectrum disorders relative to other racial groups has been well documented for the past 50 years (Oluwoye et al., 2018; Van der ven et al., 2020). Strikingly, this difference persists after controlling for socioeconomic status, discrediting the myth that these differences are largely driven by poverty. Adding to this, a study of Black consumers recently discharged from the hospital found that 54.5% of these individuals had three or less outpatient mental health visits in
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影响因子：
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