4 - (SYM 42) Perceived Staff Cultural Sensitivity and Treatment Outcomes in First-episode Psychosis Clients

Background: Client perceptions of staff/provider cultural sensitivity is critical for improved treatment outcomes, with cultural insensitivity cited as a barrier to the successful treatment of clients at first-episode psychosis (FEP). Cultural sensitivity may also be important in increasing feelings of trust in FEP clients with marginalized ethnoracial identities who are at elevated risk for suspiciousness/persecutory ideas. Given ongoing cultural competency training provided annually to all staff in the Connection Learning Healthcare System (CLHS), part of the Early Psychosis Intervention Network (EPINET) in the United States, we sought to understand associations between ethnoracial identity, perceived staff cultural sensitivity, and treatment outcomes, including suspiciousness, among CLHS FEP clients.

Methods: CLHS FEP clients (mean age=20.9 years) enrolled at one of 25 Coordinated Specialty Care treatment programs in the states of Maryland and Pennsylvania. Clients and staff completed a computerized core assessment battery at admission and every six months until program discharge, including: client-reported ethnoracial identity (nMarginalized= 773 Asian, Black, and Hispanic; nNon-Marginalized=682 Non-Hispanic White); client-reported perceived staff cultural sensitivity (Mental Health Statistics Improvement Project Youth Services Survey); clinician-assessed clinical outcomes (positive and negative symptoms; COMPASS-10); clinician-assessed functional outcomes (Global Functioning: Role and Social Scales). Moderation analyses examined the main effect of 6-month perceived staff cultural sensitivity on 12-month clinical and functional outcomes, including suspiciousness, and the interaction effects of client ethnoracial identity.

Results: Perceived staff cultural sensitivity was high, with no significant differences between Marginalized and Non-Marginalized clients (p>0.05). Moderation analyses revealed no significant main effects of perceived staff cultural sensitivity, nor significant interaction effects with client ethnoracial identity, on any clinical or functional outcomes, including suspiciousness (all p>0.05).

Discussion: Results suggest that CLHS FEP client perceptions of staff cultural sensitivity do not significantly contribute to treatment outcomes, regardless of client ethnoracial identity. Given overall high perceptions of staff cultural sensitivity, findings suggest the benefits of ongoing cultural competency training for CLHS staff.