Elsevier

Schizophrenia Research

Volume 195, May 2018, Pages 74-75
Schizophrenia Research

Invited commentary
Cultural factors in first episode psychosis treatment engagement

https://doi.org/10.1016/j.schres.2017.08.035Get rights and content

Abstract

Specialized First Episode Psychosis (FEP) services have been conceptualized in part around the issue of engagement. Creating treatment that is easier to access, with more frequent contacts, assertive outreach to clients between appointments, and an explicit youth-oriented culture could make services more attractive to those most in need of care. However, engagement has remained a mostly fuzzy, peripheral construct rather than the object of study in itself. As we recognize the importance of treatment engagement, we must prepare to address it more rigorously within psychosis and schizophrenia research. At the same time, factors enhancing or obstructing treatment engagement are inevitably local, rather than universal. The availability of care, its associated costs and stigmas, individuals' motivations for seeking treatment, and their beliefs and expectations about providers' roles are determined by local and cultural features. There can be no singular “best practice” for engagement – but curiosity about how culture and locale influence clients' willingness to participate in care, and creativity in how we account for and incorporate these variables into study designs, will help to shed light on the critical issue of engagement in FEP treatment.

Section snippets

Commentary

In this issue of Schizophrenia Research, Dr. Anika Maraj and her colleagues explore the impact of immigration and visible minority status on disengagement from care in the setting of a first episode psychosis (FEP) clinic in Montreal. The authors found similar overall rates of treatment disengagement among first-generation, second-generation, nonimmigrant, and visible minority groups, along with some suggestions that these groups may disengage for divergent reasons. This is a timely issue, as

Role of funding source

The funding source had no influence on the content of this commentary or the decision to publish.

Contributors

Dr. Kline and Ms. Thomas both contributed to and approved the final version of this commentary.

Conflict of interest

The authors have no conflicts of interest to declare.

Acknowledgements

This work was supported by NIMH grant R01MH103831 as well as the Massachusetts Department of Mental Health (SCDMH822018082610000) via the First Episode Psychosis Technical Assistance Center grant.

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