Reducing the Duration of Untreated Illness Among Youth in the Juvenile Justice System with Psychosis-Spectrum Disorders

缩短少年司法系统中患有精神病谱系障碍的青少年未治疗疾病的持续时间

• 批准号: 9763661
• 负责人: Anthony Spirito
• 金额: $ 24.43万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763661
• 关键词: Adolescence; Adolescent; Adolescent and Young Adult; Age; Applications Grants; Attitude; Awareness; Caring; Client; Clinical; Community Health; Criminal Justice; Data; Delusions; Disease; Early Intervention; Early identification; Enrollment; Ethnic Origin; Family; Future; Gender; Goals; Hallucinations; Hand; Healthcare; Human Resources; Individual; Institutes; Intake; Interview; Justice; Literature; Maps; Massachusetts; Measures; Mental Health; Mental disorders; Motivation; Outcome; Pathway interactions; Patients; Penetration; Phase; Procedures; Prognostic Factor; Protocols documentation; Psychotic Disorders; Questionnaires; Race; Recording of previous events; Reporting; Research; Rhode Island; Risk; Role; Sampling; Sensitivity and Specificity; Services; Structure; Symptoms; System; Telephone; Testing; Text Messaging; Thinking; Training; United States; Youth; associated symptom; attenuated psychosis syndrome; care systems; clinically significant; court; critical period; design; experience; first episode psychosis; follow-up; improved; instrument; intervention effect; juvenile justice system; medical specialties; population based; programs; psychiatric symptom; psychotic symptoms; screening; service intervention; standard care

Project Summary Among adolescents in the Juvenile Justice System (JJS), an estimated 3% have a psychotic illness, and it can be reasonably assumed that many more experience subthreshold psychotic- spectrum symptoms that may be indicative of risk. Evidence suggests that as many as 25% of those with first episode psychosis (FEP) have their first contact with care through criminal justice agencies. Duration of untreated psychosis (DUP), a negative prognostic factor, has been shown to be longer among those within the criminal justice system. This suggests that youth with psychotic symptoms who end up in the JJS may not receive appropriate mental health care. The current study will be conducted in the Rhode Island Family Court Juvenile Intake Department where all youth receive a mental health screen (Massachusetts Youth Screening Instrument – 2nd Ed; MAYSI -2). All youth who screen positive on the MAYSI-2 Thought Disturbance scale, and a second gate screening with the Prodromal Questionnaire – Brief Version (PQ-B), will be given referral information for Coordinated Specialty Care (CSC) services by JJS staff. Enrolled families will also participate in the research assessment, regardless of whether they pursue the CSC referral, which involves the Structured Interview for Psychosis-risk Syndromes [SIPS] and other measures to thoroughly assess history of psychotic symptoms, comorbid difficulties, and mental health care engagement. A comparison sample of youth who screen negative on the MAYSI-2 Thought Disturbance subscale will also be assessed with the SIPS to determine accuracy of the MAYSI-2/PQ-B screen in the identification of psychosis-risk. During the first phase of the study, JJS staff will follow standard procedures in referring youth to the state CSC. In the second phase of the study, JJS will be instructed in an enhanced referral/linkage to care protocol, including a “warm hand-off” where referrals will be put in direct and immediate contact with CSC staff. CSC staff will also be trained in procedures to increase the likelihood of follow through with the referral to the CSC. Three month follow-up qualitative interviews and quantitative assessments regarding referral pathways, bottlenecks and gaps in care, youth psychiatric symptoms, and JJS contacts will be conducted. This design maps onto the stated goals of PAR 16- 264 including: 1) Identify baseline rates of DUP within the JJS (and we will also look at rates of psychosis-spectrum symptoms and disorders); 2) Map referral pathways to CSC; 3) Identify implementation and service level factors that create bottlenecks and gaps in linkage to the CSC; 4) Investigate the relationship between treatment linkage and psychotic symptoms/DUP; and, 5) Pilot test feasible strategies for reducing DUP.

项目总结