Abstract

Aversive pathways to coordinated specialty care (CSC) for first episode psychosis have been linked to the extended duration of untreated psychosis, limited engagement, and treatment outcomes. Yet there has been very limited research that has solely explored the unique pathways to care among Black families in the U.S. This study utilized qualitative methods to explore the pathways to CSC among Black individuals experiencing their first episode of psychosis and their family members. Individuals who were or are enrolled in CSC programs and/or their family members were recruited to participate in semi-structured qualitative interviews. Qualitative interviews were used to characterize events and experiences prior to the initiation of CSC. All interviews were transcribed verbatim and analyzed using a qualitative descriptive approach. A total of 14 participants were recruited to complete semi-structured interviews. Findings revealed that during prodromal phase participants noticed changes in social functioning, identified prior childhood experiences that were viewed as traumatic, and sought very little help from formal sources. After the onset of psychosis, the majority of participants highlighted the importance of family members in the initiation of care, yet also expressed difficulties navigating services and engaging with clinical staff, contributing to further delays to the initiation of CSC. Finding from this study sheds light on understanding known disparities in utilization of services and potentially identifies areas that can be leveraged to improve the experiences for Black families seeking CSC.

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