Examining the Effectiveness of a Digital Media Campaign at Reducing the Duration of Untreated Psychosis in New York State: Results From a Stepped-wedge Randomized Controlled Trial

Author:

Birnbaum Michael L123,Garrett Chantel4,Baumel Amit5,Germano Nicole T1,Sosa Danny1,Ngo Hong6,John Majnu12,Dixon Lisa6,Kane John M123ORCID

Affiliation:

1. The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health , Glen Oaks, NY , USA

2. The Feinstein Institute for Medical Research , Manhasset , NY , USA

3. The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Hempstead, NY , USA

4. Strong365 Lab , Orinda, CA , USA

5. Department of Community Mental Health, University of Haifa , Haifa , Israel

6. Department of Psychiatry, New York State Psychiatric Institute , New York, NY , USA

Abstract

Abstract Background and Hypothesis Longer duration of untreated psychosis (DUP) predicts worse outcomes in First Episode Psychosis (FEP). Searching online represents one of the first proactive step toward treatment initiation for many, yet few studies have informed how best to support FEP youth as they engage in early online help-seeking steps to care. Study Design Using a stepped-wedge randomized design, this project evaluated the effectiveness of a digital marketing campaign at reducing DUP and raising rates of referrals to FEP services by proactively targeting and engaging prospective patients and their adult allies online. Study Results Throughout the 18-month campaign, 41 372 individuals visited our website, and 371 advanced to remote clinical assessment (median age = 24.4), including 53 allies and 318 youth. Among those assessed (n = 371), 53 individuals (14.3%) reported symptoms consistent with psychotic spectrum disorders (62.2% female, mean age 20.7 years) including 39 (10.5%) reporting symptoms consistent with either Clinical High Risk (ie, attenuated psychotic symptoms; n = 26) or FEP (n = 13). Among those with either suspected CHR or FEP (n = 39), 20 (51.3%) successfully connected with care. The campaign did not result in significant differences in DUP. Conclusion This study highlights the potential to leverage digital media to help identify and engage youth with early psychosis online. However, despite its potential, online education and professional support alone are not yet sufficient to expedite treatment initiation and reduce DUP.

Funder

NIMH

Publisher

Oxford University Press (OUP)

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