UC Irvine

Clinical high-risk (CHR) for psychosis is associated with distress, impairment, and elevated risk for developing full threshold psychosis. Though early intervention can improve prognostic outcomes in early psychosis, research on factors related to utilization of mental health services among individuals at CHR is limited. Given racial inequities in mental health care and links between CHR and sociocultural/contextual factors, an exploration of contextual correlates of mental health care utilization is needed. We conducted a secondary data analysis of an ongoing community psychosis-risk study to examine whether racialized identity, social support, racial discrimination, immigration status, and symptom severity are related to mental health care utilization among youth and young adults at CHR. Participants in the study are 16-30 year-olds who meet interview-based criteria for a psychosis-risk syndrome (n=180). Participants self-reported social support, experiences of discrimination, immigration status, and lifetime mental health care use. In regression analyses, Asian/Asian American participants were significantly less likely than White/European American participants to report receiving past mental health care, as were immigrants compared to those born in the United States. Black/African American participants were significantly less likely to report using services currently compared to White/European American participants, and distressing positive symptoms also significantly predicted receiving current services in the full sample. Overall, recent positive symptoms may be more closely associated with current service use, while sociocultural factors such as immigration status and racial identity may impact initial entry into or use of the mental health care system. As CHR research and practice increasingly focus on early intervention, findings underscore the importance of better understanding factors associated with mental health service use among youth at CHR.