Ethnic diversity and pathways to care for a first episode of psychosis in Ontario.
OBJECTIVE
To examine ethnic variations in the pathways to care for persons accessing early intervention (EI) services in Ontario.


METHODS
The pathways to care and the duration of untreated psychosis were assessed for first-episode psychosis patients who entered specialized EI services in Ontario. The sample was assigned to the following ethnic classifications: the White (Caucasian), Black (African descent), and Asian (ancestry from the continent) groups, plus all the "other ethnicities" group.


RESULTS
There were 200 participants: 78% were male; 61% from the White, 15% Black, 13% Asian, and 11% were from the other ethnicities group. At the first point of contact, more participants used nonmedical contacts (12%), such as clergy and naturopathic healers, than psychologists (8%) or psychiatrists (7%). There were no ethnic differences for duration of untreated psychosis (median 22 weeks) or for initiation of help seeking by family/friends (53%), police (15%), or self (33%). After adjusting for relevant clinical and demographic factors, the Asian and other ethnicities groups were 4 and 3 times (respectively) more likely than the White or Black groups (P = .017) to use emergency room services as the first point of contact in the pathways to care. Participants from the Asian group experienced less involuntary hospitalizations (P = .023) than all the other groups. Yet overall, there were many more similarities than significant differences in the pathways to care.


CONCLUSIONS
EI services should monitor the pathways to care for young people of diverse ethnic backgrounds to address any disparities in accessing care.
Archie
S
S
McMaster University, Hamilton, Ontario, Canada. archies@mcmaster.ca
Akhtar-Danesh
N
N
Norman
R
R
Malla
A
A
Roy
P
P
Zipursky
R B
RB
D000069:Acculturation; D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000523:psychology* / Q000706:statistics & numerical data; D044383:Black People / Q000523:psychology* / Q000706:statistics & numerical data; D003134:Commitment of Persons with Psychiatric Disorders; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019303:Multilingualism; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D012559:Schizophrenia / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D012565:Schizophrenic Psychology; D014505:Urban Population / Q000706:statistics & numerical data*; D014600:Utilization Review; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult