Grant: Operating Grant

The sooner an individual gets treatment for psychotic illnesses such as schizophrenia, the better the outcome. In an effort to assist this goal, early intervention services have been set up across Ontario. However, studies of these services suggest that there is a greater delay between developing symptoms of psychosis and getting treatment in people of African and Caribbean origin than European Canadians. These delays may lead to more severe illness with worse prognosis and more involvement of emergency services and the prison and justice systems. The reason for the differences between groups is not clear. It could be that people of African and Caribbean origins are less likely to know how to get help from first episode services, or that they are less likely to attend their general practitioner and be referred to services, or the fact that some in these groups may prefer to use complementary therapies before trying first episode services. In order to promote early treatment and better outcome, a clear understanding is needed of the different routes people take to getting care and why they take a particular route. For instance if there is significant delay in treatment because of the use of complementary treatment, health planners may want to work with complementary therapists in areas where people of African and Caribbean origin live in order to develop better pathways to first episode care. This study will document and compare the pathways taken to first episode psychosis services for African, Caribbean and European origin Canadians living in Toronto. Pathways to care will be assessed using a methodology designed by the World Health Organization. Where differences in pathways are identified, the study will use focus groups involving clients, their families, carers and community members to help researchers further understand the reasons why these occur. This information could form the basis of targeted interventions to increase health equity in Ontario.