Reducing the Duration of Untreated Psychosis through Community Education

描述（由申请人提供）：大多数旨在减少未治疗精神病（DUP）持续时间的信息活动都是不成功的。此外，人们很少关注高风险、文化多样化的群体。本应用程序的总体目标是通过为信息活动的发展带来更多的科学严谨性，并通过为多样化、高风险社区开展可持续的活动来扩大其影响范围，从而加强信息活动的有效性。居住在洛杉矶县高密度拉丁裔（主要是墨西哥裔）社区的讲西班牙语的青少年和成年人（15-64岁）将作为目标群体。这一群体患DUP的风险很高，因为他们的精神卫生服务使用率很低，而且移民的比例很大，因为移民的精神疾病发病率较高。为了实现总目标，将开展一项多层次、多平台的西班牙语交流运动(a)以提高讲西班牙语的青少年和成年人对精神病的认识；(b)降低拉丁裔首发精神病患者（FEP）的DUP，以及(c)探讨DUP与FEP患者及其照顾者的精神病素养之间的关系。嵌入在多种媒体格式中的是中心信息：“使用La CLAve（线索）来检测你所爱的人的严重精神疾病”，这一信息已在提高精神病知识的初步研究中得到证实。La CLAve既是首字母缩略词，也是帮助人们记住精神病主要症状的助记工具。为了提高社区中心的可持续性，将对社区的多个层面（个人、护理促进者、社区资源和精神卫生机构）进行管理，将向主要社区人员分发信息宣传活动的主副本，并对社区人员进行培训，以管理社区中心的关键方面。将在基线、18个月和36个月三个时间点对代表性家庭（每波500户）进行调查。预计在3年期间，精神病知识的普及将得到提高和维持。为了评估DUP是否减少，圣费尔南多心理健康诊所的接待工作人员将确定所有传入的拉丁裔FEP患者在4年内的DUP。

DESCRIPTION (provided by applicant): Most informational campaigns to reduce the duration of untreated psychosis (DUP) have been unsuccessful. Moreover, there has been little attention given to high-risk, culturally diverse groups. The overall objective of this application is to strengthen the effectiveness of informational campaigns by bringing more scientific rigor to their development and by extending their reach through sustainable campaigns for diverse, high-risk communities. Spanish-speaking adolescents and adults (ages 15-64) residing in a high density (>80%) Latino (largely Mexican origin) community within Los Angeles County will serve as the target group. This group is at high risk for DUP given its low rates of mental health service use and its large proportion of immigrants because immigrants have elevated incidence rates of psychotic disorders. To achieve the overall objective, a multi-level and multi-platform Spanish language Communication Campaign (CC) will be carried out (a) to increase the psychosis literacy of Spanish-speaking adolescents and adults; (b) to reduce the DUP for Latinos with first-episode psychosis (FEP), and (c) to explore the relationship between DUP and the psychosis literacy of individuals with FEP and their caregivers. Embedded in the multiple media formats is the central message: "Use La CLAve (the clue) to detect serious mental illness in your loved ones", a message that has been shown in preliminary studies to increase psychosis literacy. La CLAve is both an acronym and mnemonic device to help people remember the key symptoms of psychosis. To enhance the sustainability of the CC, multiple levels of the community (individuals, care facilitators, community resources, and the mental health institution) will be administered the program, master copies of the informational campaign will be distributed to key community personnel, and community personnel will be trained to administer key aspects of the CC. To assess the penetration and sustainability of the IC, surveys will be conducted of representative households (N = 500 for each wave) at three time points: baseline, 18 months and 36 months. An increase and maintenance of psychosis literacy is expected over the 3-year period. To assess whether there is a reduction of DUP, intake workers at San Fernando Mental Health Clinic will identify the DUP for all incoming Latino patients with FEP over a 4-year period. Based on incidence rates of psychotic disorders and the population of the targeted community, 60 Latino patients with FEP are expected each year (N = 240). Compared to a 1-year baseline, the DUP is expected to decrease significantly over the next 3 years. To explore the relationship of individual's DUP and psychosis literacy, the psychosis literacy and referral sources of all new FEP patients and their caregivers will be among the relevant variables that are examined. The proposed research program has the potential to lead a second generation of DUP reduction programs, one that has a strong evidence base and that reaches many in need, including those underserved groups with high risk for prolonged DUP.