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Impact of rurality and substance use on young people at ultra high risk for psychosis
Author(s) -
Stain Helen J.,
Halpin Sean A.,
Baker Amanda L.,
Startup Mike,
Carr Vaughan J.,
Schall Ulrich,
Crittenden Kylie,
Clark Vanessa,
Lewin Terry J.,
Bucci Sandra
Publication year - 2018
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12437
Subject(s) - rurality , mental health , psychological intervention , medicine , intervention (counseling) , depression (economics) , psychiatry , rural area , psychosis , psychology , environmental health , pathology , economics , macroeconomics
Background Longitudinal research into early intervention for youth at ultra high risk ( UHR ) for psychosis demonstrates beneficial outcomes including increased treatment compliance and greater participation in education and the workforce. Despite known barriers for rural youth accessing mental health services, research comparing urban and rural UHR youth is lacking. The study included an examination of the impact of substance use on functioning of UHR youth. Methods Youth aged 12 to 25 years were recruited from the urban area of Newcastle or the rural area of Orange, New South Wales, Australia, and identified as UHR by the Comprehensive Assessment of At Risk Mental States. Rural and urban youth were compared on clinical profiles, social and occupational functioning and substance use. Results The rural youth showed different help‐seeking behaviours and had greater functional impairment than urban youth. Substance use was common across the sample of 57 youth (mean age 16.5 years, 56% female) and a history of hazardous substance use was associated with higher levels of depression. Rural youth (n = 32) were more likely than urban youth to be taking antidepressants at baseline (44% compared with 16%). Conclusion Different patterns of help seeking by rural UHR youth suggest a need for greater access to psychosis informed primary care early intervention services. Interventions should target functional decline to prevent adverse outcomes such as reduced community participation and unemployment. In addition, interventions for substance use should be a priority for UHR youth, who should also be screened and monitored for depressive symptoms and treated for depression if indicated.