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History of Legal Involvement Among Individuals With First Episode Psychosis in the Connection Learning Healthcare System Hub of the Early Psychosis Intervention Network
Journal article   Peer reviewed

History of Legal Involvement Among Individuals With First Episode Psychosis in the Connection Learning Healthcare System Hub of the Early Psychosis Intervention Network

Jessie Riggs, Megan Jumper, Arielle Ered, Catherine Conroy, Hailey Mileen Fasone, Chelsea R Jackson, Christian G. Kohler, Melanie Bennett and Monica E. Calkins
Early intervention in psychiatry, v 19(S1), 16302
May 2025

Abstract

Aims: We aim to expand the currently limited knowledge of the prevalence and characteristics of first episode of psychosis (FEP) program participants in Coordinated Specialty Care (CSC) with a history of legal involvement (HLI). Methods: Participants (n = 1959) experiencing FEP admitted to Pennsylvania and Maryland (USA) CSC programs were assessed using a standardized core assessment battery, including history of legal involvement (HLI). Sociodemographic characteristics and clinical features were compared in adolescents/young adults with (n = 288) and without (n = 1671) HLI, through chi-square, Fisher's exact, and Mann–Whitney U tests. Results and Conclusion: Participants with HLI were disproportionately Black (49.7%), and less likely to be enrolled in school (19.4%) than those without HLI (40.3%; 41.7%). Those with HLI were older (age M = 22.6, SD = 4.13) with a longer duration of untreated psychosis (DUP M = 15.03, SD = 23.56), and more likely to have a previous psychiatric hospitalization (87.5%) than those without HLI (age M = 20.73, SD = 4.18; DUP M = 12.49, SD = 19.46; hospitalization = 77.8%; p's < 0.05). Participants with HLI had lower baseline Global Function Role and Social (Role M = 4.03, SD = 2.52; Social M = 4.89, SD = 1.91) than those without HLI (Role M = 4.98, SD = 2.46; Social M = 5.53, SD = 1.92; p's < 0.05). Results reflect associations among the pathways to, and timing of, a history of legal involvement and FEP program admission. Notably, CSC participants with HLI have experienced a longer DUP and higher likelihood of hospitalization than those without HLI. Our findings underscore the importance of access to early intervention, particularly in USA. Black communities, to potentially reduce legal involvement and acute entry into the mental health system.

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