An Evaluation of Patient Outings in a Community-Based CSC Program for Youth with Psychosis and Frequent Substance Use
Morgan Ellis, MHS (1), Agata Bereznicka, MPH (1), Julia Browne, PhD (1, 2), Christian Wulff, LCSW (1), Anne Berrigan, LICSW (1), Jennifer Lancet, MBA, MS (1), Hannah E. Brown, MD (1, 2), Amy M. Yule, MD (1, 2)
1: Department of Psychiatry, Boston Medical Center (BMC), Boston, MA
2: Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, MA
Background: Social isolation is common in adolescents and young adults (AYA) with psychosis and has been correlated with prolonged duration of untreated psychosis. Moreover, AYA with substance use and psychosis often struggle to find positive prosocial activities that do not involve using substances. To address this, the WRAP Without Walls (WWW) Community-Based Coordinated Specialty Care Program introduced program-led group outings within the community to increase social engagement.
Methods: We analyzed participation and the cost of social outings that occurred in the programs' third year (06/24-07/25). Participation data was collected from the medical record and a prosocial rewards tracker. Cost data was collected from receipts from outings and rideshares. We categorized outings into recurring events (i.e., basketball) and non-recurring events (e.g., movies, ice skating, etc.)
Results: During this period, 16 patients attended at least one outing which included 5 recurring events and 10 non-recurring events. Of the 36 active patients during this time period, 61% were Black/African American and 26% Hispanic/Latino, with an average psychosis onset at age 18.2 and WWW enrollment at age 21.9. There were no statistically significant differences in these variables between attendees and non-attendees of the outings. Among the patients who attended outings, 29% went to 5+ events. Non-reoccurring events averaged 4 participants per outing, with a median of $49.83/patient/event and 54% of patients requiring rideshare services the events, with a median of $30.39 roundtrip per patient per event. For recurring events the event itself was associated with minimal cost but 75% of participants used rideshare services, with a median of $18.85 roundtrip/patient.
Conclusion: Offering group outings in the community is viable within a program for youth with psychosis and frequent substance use. Participation in outings and the costs associated with outings vary.