Disconnection from care among adolescents with psychotic experiences

To better understand preventative service connection, this study describes the proportion of adolescents with psychotic experiences, a known transdiagnostic risk factor, who have spoken with healthcare providers about their mental health in the past year.

A brief mental health survey was administered to 38,569 students across 28 middle and 38 high schools in Massachusetts in the years 2020-2022. The 13,458 middle school students had a mean age of 12, 47 % were biologically male, 59 % were White, and 23 % were Hispanic/Latino. The 25,111 high school students had a mean age of 16, 46 % were biologically male, 71 % were White, and 16 % were Hispanic/Latino. Seven psychotic experiences were assessed along with one question asking whether the student had spoken with any health provider in the past year about their emotional wellbeing.

Across the three years, 27 % of middle school students, and 16 % of high school students endorsed at least one psychotic experience. Only 34 % of middle school students and 23 % of high school students with a psychotic experience had spoken with a provider in the past year about their mental health. Males and middle school students with psychotic experiences were significantly less likely to speak with a provider across all three years than females and high school students (ps<0.01).

These findings further highlight the need for improved mental health education for adolescents, family members, and educators, including specific information about psychiatric risk factors and pathways to mental health support for young people to encourage more help-seeking behaviors.