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Pathways Through Early Psychosis Care for U.S. Youths From Ethnically and Racially Minoritized Groups: A Systematic
Neely Myers1, Matthew Hutnyan1, Tamara C Daley1
1Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro).
Objective:
The authors of this systematic review examined service utilization and outcomes among youths from ethnoracially minoritized groups after the youths initiated treatment for a psychotic disorder-that is, the youths' "pathway through care." Also examined were potential moderating variables in pathways through care for these youths at the clinic, family, and cultural levels. The goal was to describe methodologies, summarize relevant findings, highlight knowledge gaps, and propose future research on pathways through care for young persons from ethnoracially minoritized groups who experience early psychosis.
Methods:
The PubMed, PsycInfo, and Web of Science literature databases were systematically searched for studies published between January 1, 2010, and June 1, 2021. Included articles were from the United States and focused on young people after they initiated treatment for early psychosis. Eighteen studies met inclusion criteria.
Results:
Sixteen of the 18 studies were published in the past 5 years, and 11 had an explicit focus on race and ethnicity as defined by the studies' authors. Studies varied in terminology, outcomes measures, methodologies, and depth of analysis. Being an individual from an ethnoracially minoritized group appeared to affect care utilization and outcomes. Insufficient research was found about potential moderating variables at the clinic, family, and cultural levels.
Conclusions:
Studies of pathways through care for persons from minoritized groups warrant further funding and attention.
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