All young persons are faced with the decision of how to invest in their human capital development; this normative tension is particularly pronounced for young persons who have experienced a first episode of psychosis (FEP). Interruptions in their education and employment following FEP can lead not only to poor socioeconomic outcomes, but also impair psychiatric recovery. FEP treatment programs have demonstrated effectiveness in improving outcomes and reducing the probability of disability for newly-diagnosed young persons with schizophrenia and related disorders. FEP programs have indicated a need for knowledge to help clients navigate the developmental milestone of choosing investments in school and work. Training Plan: This K01 Award will train the candidate to become an independent investigator conducting policy analysis to improve psychiatric and socioeconomic outcomes for persons with psychiatric disorders. This K01 will provide training in 1) clinical and policy elements of FEP treatment and 2) SEE services, 3) the impact of racial/ethnic disparities on SEE access and engagement, and 4) methodological training in mixed (quantitative and qualitative) methods data collection and analysis. These skills, combined with my quantitative analysis training and commitment to promoting socioeconomic recovery of individuals with psychiatric disorders, will give me the tools I need to launch an independent research career. Research Plan: This study will develop policy recommendations to help policymakers and program leaders identify how best to provide SEE services to clients with FEP, to enable clients to make a meaningful choice of SEE services.
The Specific Aims are: 1) To identify predictors of human capital attainment in a population-based survey among persons who report symptoms of psychosis, prior to the availability of comprehensive FEP programs; 2) To identify predictors, barriers, and challenges to the use of SEE services in FEP treatment programs; and 3) To examine SEE and FEP service utilization patterns over the duration of FEP treatment. Methodology: The mentored research project will encompass secondary data analyses from a nationally-representative sample of US adults (the Collaborative Psychiatric Epidemiology Surveys), from the Improving Work Outcomes study at the University of California Los Angeles, and from the New York State initiative, OnTrackNY. Primary data will be collected from semi-structured interviews with program staff at existing FEP programs, and staff and clients at the New York State OnTrackNY initiative. A meta-analysis will be conducted with data from OnTrackNY and the Recovering After an Initial Schizophrenia Episode (RAISE) Connection. At the conclusion of the K01, the findings will be reviewed by OnTrackNY leadership, to lay out a series of policy options that can help to improve SEE service delivery and utilization. The policy environment is ripe for identifying models that can lead to long-term improvements in psychiatric functioning and reduce disability, and could be expanded to young adults with other psychiatric disorders.
This study addresses Objective 3, Strategy 3.4 of the NIMH Strategic Plan: Identify and systematically study elements of personalized mental health care. The results from this K01 will help FEP programs personalize their provision of supported education and/or employment services, to allow them to adapt to the needs and circumstances of individuals they are designed to help.
