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Child Psychiatrist /Adult Psychiatrist

New York Digital Media Campaign Does Not Improve Duration of Untreated Psychosis

Keypoint: A digital media campaign was able to target individuals experiencing early psychosis, but did not improve treatment outcomes.

A digital media campaign in New York State showed promise in identifying and engaging young individuals experiencing early psychosis online. However, the campaign did not result in significant improvements in the prompt initiation of treatment and duration of untreated psychosis (DUP), according to study results published in Schizophrenia Bulletin.

Digital Media Campaign

Although many young people in the United States experience a first episode of psychosis (FEP), there is often a significant amount of time before individuals begin treatment. Because of the adverse health outcomes associated with prolonged DUP, researchers and health officials have increasingly explored methods to increase treatment engagement and shorten DUP.

To this aim, investigators conducted a stepped-wedge randomized controlled trial ( Identifier: NCT03975400) to evaluate the efficacy of a digital marketing campaign aimed at reducing DUP and increasing referrals to FEP services in New York State.

The campaign began in October 2020 and expanded in October 2021, targeting 6 clusters of FEP programs across New York. Each cluster underwent the intervention at varying intervals over 18 months, enabling a comparison between the intervention and control conditions before granting all sites access to the campaign. The digital campaign was advertised to target audiences who searched for relevant key terms. Once on the website, individuals were invited to take a quiz and interact with the website. The website also provided peer/clinician support and could refer individuals to mental health/social services.

Participants received remote clinical assessments via text or video, identifying psychiatric symptoms and treatment history. Referral options were determined weekly based on clinical information, with suspected FEP referred to programs. The campaign also engaged individuals with suspected clinical high risk (CHR), schizophrenia spectrum disorder, or other psychotic disorders, offering referrals based on their needs.

A total of 41,372 visitors accessed the website, of whom 371 proceeded to remote clinical assessment. Out of the 371 individuals assessed, 14.3% (n=53) reported symptoms aligned with psychotic spectrum disorders and these individuals were primarily girls/women (62.2%).

Within the cohort of individuals with psychosis symptoms, 10.5% (n=39) showed symptoms consistent with either CHR or FEP, of which 51.3% (n=20) successfully accessed care. Most individuals suspected of CHR (n=26) or FEP (n=13) had no prior treatment (62%). Median durations of psychotic experiences were 1 to 2 years for suspected FEP and 6 months or less for suspected CHR. Among individuals who declined care (n=19), common barriers included lack of familial support, feeling unprepared for psychiatric treatment, and geographical obstacles.

The campaign had no significant impact on the DUP or the number of referrals to programs for FEP participants. The DUP was similar between the control period (204.2 days) and the campaign period (196.3 days; P =.70), with no notable difference observed). Similarly, the number of program referrals and new admissions showed minimal change between the 2 periods.

“This study highlights that online education and professional support alone are not sufficient to overcome help-seeking barriers and that new approaches must be developed to effectively advance the work,” the investigators concluded.

Study limitations include the difficulty in assessing the COVID-19 pandemic’s influence on campaign effectiveness, the absence of comprehensive diagnostic assessments, and the potential lack of generalizability to locations outside of New York.

Disclosures: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Note: This article originally appeared on Psychiatry Advisor

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