Skip to main content

Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study

Social Psychiatry and Psychiatric Epidemiology (2022)Cite this article

Abstract

Purpose

In the US, Black people diagnosed with schizophrenia experience worse psychosocial and clinical outcomes than their White counterparts. While racism-related factors contribute to these disparities, an additional understudied explanation may be that psychosocial treatments for psychotic disorders are less effective for Black than White individuals. The purpose of this study is to examine the extent to which best treatment practices for first-episode psychosis (FEP) are effective for Black and White participants.

Methods

We conducted a secondary data analysis of the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP), a two-year multisite trial that compared a coordinated specialty care intervention for FEP (NAVIGATE) to community care as usual (CC) in 34 sites across the US. Specifically, we compared interviewer-rated quality of life and symptoms, as well as self-reported mental health and stigma, between 139 Non-Latinx Black and 172 Non-Latinx White participants with FEP in NAVIGATE and CC.

Results

We found few differences between Black and White participants over two-year outcomes, either overall or in terms of benefit from NAVIGATE. Across both treatment conditions, Black participants improved less than White participants on positive symptoms, an effect driven primarily by suspiciousness/persecution. In NAVIGATE, self-reported mental health stigma decreased for both Black and White participants, while in CC stigma decreased for White participants but increased for Black participants. This effect was driven primarily by experienced stigma rather than self-stigma.

Conclusion

NAVIGATE benefits both Black and White individuals diagnosed with FEP. Mental health stigma and positive symptoms may be particularly important aspects of treatment for Black individuals diagnosed with FEP.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

Availability of data and material (data transparency)

The RAISE-ETP dataset is publicly available through the National Institutes of Mental Health.

Code availability

N/A.

Notes

  1. The reasons why Black participants were more likely to receive first- rather than second-generation antipsychotic medications was not addressed by the cited paper. Other extant literature suggests that there are several possible reasons: (a) Receipt of poorer quality care for African Americans; (b) Cost restrictions (e.g., due to poorer insurance quality); and (c) concerns about certain side effects (e.g., hypertension) that might be higher in African Americans. Puyat et al. [41] has published a meta-analysis on this topic.

  2. A previous paper that examined baseline demographic differences between Black and White participants in the RAISE-ETP study found that a greater proportion of White participants than Black participant were male [40]. The same pattern was observed in this study but did not reach statistical significance (p = 0.09). The difference in findings emerged because Nagendra et al. [40] included Latinx participants while this study considered Latinx individuals a separate racial/ethnic group.

  3. Notably, our findings are similar but not identical to findings from Oluwoye et al. [42] using the same data. Specifically, Oluwoye et al. [42] reported that in CC, Black participants showed less improvement in positive symptoms than White participants but in NAVIGATE, there were no differences between the two groups. While our models did not detect a significant three-way interaction, an examination of graphed interactions suggested that the lower rate of improvement for Black participants was driven more strongly by CC than NAVIGATE. The slight discrepancy between our study and that of Oluwoye et al. [42] may have emerged due to differences between the two studies in the statistical models, covariates, and PANSS factor models used.

References

  1. Olbert CM, Nagendra A, Buck B (2018) Meta-analysis of Black vs. White racial disparity in schizophrenia diagnosis in the United States: do structured assessments attenuate racial disparities? J Abnorm Psychol 127:104–115. https://doi.org/10.1037/abn0000309

    Article  PubMed  Google Scholar 

  2. Folsom DP et al (2005) Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. Am J Psychiatry 162:370–376. https://doi.org/10.1176/appi.ajp.162.2.370

    Article  PubMed  Google Scholar 

  3. Kuno E, Rothbard AB, Averyt J, Culhane D (2000) Homelessness among persons with serious mental illness in an enhanced community-based mental health system. Psychiatr Serv 51:1012–1016. https://doi.org/10.1176/appi.ps.51.8.1012

    CAS  Article  PubMed  Google Scholar 

  4. Baillargeon J, Binswanger IA, Penn JV, Williams BA, Murray OJ (2009) Psychiatric disorders and repeat incarcerations: the revolving prison door. Am J Psychiatry 166:103–109. https://doi.org/10.1176/appi.ajp.2008.08030416

    Article  PubMed  Google Scholar 

  5. Prince JD, Akincigil A, Bromet E (2014) Incarceration rates of persons with first-admission psychosis. Psychiatr Serv 58:1173–1180. https://doi.org/10.1176/ps.2007.58.9.1173

    Article  Google Scholar 

  6. Rosenheck R et al (2006) Barriers to employment for people with schizophrenia. Am J Psychiatry 163:411–417. https://doi.org/10.1176/appi.ajp.163.3.411

    Article  PubMed  Google Scholar 

  7. Salkever DS et al (2007) Measures and predictors of community-based employment and earnings of persons with schizophrenia in a multisite study. Psychiatr Serv 58:315–324. https://doi.org/10.1176/ps.2007.58.3.315

    Article  PubMed  Google Scholar 

  8. Eack SM, Newhill CE (2012) Racial disparities in mental health outcomes after psychiatric hospital discharge among individuals with severe mental illness. Soc Work Res 36:41–52. https://doi.org/10.1093/swr/svs014

    Article  PubMed  PubMed Central  Google Scholar 

  9. Rockett IRH et al (2009) Discrepant comorbidity between minority and white suicides: national multiple cause-of-death analysis national multiple cause-of-death analysis. BMC Psychiatry. https://doi.org/10.1186/1471-244X-9-10

  10. Barnes A (2004) Race, schizophrenia, and admission to state psychiatric hospitals. Adm Policy Ment Health 31:241–252. https://doi.org/10.1023/B:APIH.0000018832.73673.54

  11. Rost K, Hsieh Y-P, Xu S, Menachemi N, Young AS (2011) Potential disparities in the management of schizophrenia in the United States. Psychiatr Serv 62:613–618. https://doi.org/10.1176/ps.62.6.pss6206_0613

  12. Snowden LR, Hastings JF, Alvidrez J (2009) Overrepresentation of Black Americans in psychiatric inpatient care. Psychiatr Serv 60:779–785. https://doi.org/10.1176/ps.2009.60.6.779

    Article  PubMed  Google Scholar 

  13. Hamilton JE, Heads AM, Cho RY, Lane SD, Soares JC (2015) Racial disparities during admission to an academic psychiatric hospital in a large urban area. Compr Psychiatry 63:113–122. https://doi.org/10.1016/j.comppsych.2015.08.010

    Article  PubMed  Google Scholar 

  14. Li H, Eack SM, Montrose DM, Miewald JM, Keshavan M (2011) Longitudinal treatment outcome of African American and Caucasian patients with first episode psychosis. Asian J Psychiatr 4:266–271. https://doi.org/10.1016/j.ajp.2011.08.004

    Article  PubMed  PubMed Central  Google Scholar 

  15. Anglin DM et al (2021) From womb to neighborhood: a racial analysis of social determinants of psychosis in the United States. Am J Psychiatry 178:599–610. https://doi.org/10.1176/appi.ajp.2020.20071091

    Article  PubMed  PubMed Central  Google Scholar 

  16. Merritt-Davis OB, Keshavan MS (2006) Pathways to care for African Americans with early psychosis. Psychiatr Serv 57:1043–1044. https://doi.org/10.1176/ps.2006.57.7.1043

  17. van der Ven E, Bourque F, Joober R, Selten J-P, Malla AK (2012) Comparing the clinical presentation of first-episode psychosis across different migrant and ethnic minority groups in Montreal, Quebec. Can J Psychiatry 57:300–308. https://doi.org/10.1177/070674371205700505

    Article  PubMed  Google Scholar 

  18. Eack SM, Bahorik AL, Newhill CE, Neighbors HW, Davis LE (2012) Interviewer-perceived honesty as a mediator of racial disparities in the diagnosis of schizophrenia. Psychiatr Serv 63:875–880. https://doi.org/10.1176/appi.ps.201100388

    Article  PubMed  PubMed Central  Google Scholar 

  19. Schwartz RC, Blankenship DM (2014) Racial disparities in psychotic disorder diagnosis: a review of empirical literature. World J Psychiatry 4:133–140. https://doi.org/10.5498/wjp.v4.i4.133

    Article  PubMed  PubMed Central  Google Scholar 

  20. Trierweiler SJ, Neighbors HW, Munday C, Thompson EE, Jackson JS, Binion VJ (2006) Differences in patterns of symptom attribution in diagnosis schizophrenia between African American and Non-African American clinicians. Am J Orthopsychiatry 76:154–160. https://doi.org/10.1037/0002-9432.76.2.154

    Article  PubMed  Google Scholar 

  21. Anglin DM, Lighty Q, Greenspoon M, Ellman LM (2014) Racial discrimination is associated with distressing subthreshold positive psychotic symptoms among US urban ethnic minority young adults. Soc Psychiatry Psychiatr Epidemiol 49:1545–1555. https://doi.org/10.1007/s00127-014-0870-8

    Article  PubMed  Google Scholar 

  22. Oh H, Cogburn CD, Anglin D, Lukens E, DeVylder J (2016) Major discriminatory events and risk for psychotic experiences among Black Americans. Am J Orthopsychiatry 86:277–285

    Article  Google Scholar 

  23. Oluwoye O, Davis B, Kuhney FS, Anglin DM (2021) Systematic review of pathways to care in the US for Black individuals with early psychosis. Npj Schizophr 7. https://doi.org/10.1038/s41537-021-00185-w

  24. Maura J, Weisman de Mamani A (2017) Mental health disparities, treatment engagement, and attrition among racial/ethnic minorities with severe mental illness: a review. J Clin Psychol Med Settings 24:187–210. https://doi.org/10.1007/s10880-017-9510-2

    Article  PubMed  Google Scholar 

  25. Knight S, Jarvis GE, Ryder AG, Lashley M, Rousseau C (2022) Ethnoracial differences in coercive referral and intervention among patients with first-episode psychosis. Psychiatr Serv 73:2–8. https://doi.org/10.1176/appi.ps.202000715

    Article  PubMed  Google Scholar 

  26. Rotenberg M, Tuck A, Ptashny R, McKenzie K (2017) The role of ethnicity in pathways to emergency psychiatric services for clients with psychosis. BMC Psychiatry. https://doi.org/10.1186/s12888-017-1285-3

  27. Mausbach BT et al (2008) Evaluation of a culturally tailored skills intervention for Latinos with persistent psychotic disorders. Am J Psychiatr Rehabil 11:61–75. https://doi.org/10.1080/15487760701853102

    Article  PubMed  Google Scholar 

  28. Degnan A et al (2018) The nature and efficacy of culturally-adapted psychosocial interventions for schizophrenia: a systematic review and meta-analysis. Psychol Med 48:714–727. https://doi.org/10.1017/S0033291717002264

    CAS  Article  PubMed  Google Scholar 

  29. Rathod S, Kingdon D, Phiri P, Gobbi M (2010) Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients by exploration and incorporation of service users’ and health professionals’ views and opinions. Behav Cogn Psychother 38:511–533. https://doi.org/10.1017/S1352465810000378

    Article  PubMed  Google Scholar 

  30. DeTore NR, Balogun-Mwangi O, Mueser KT, McGurk SR (2021) Comparison of Black and White participants with severe mental illness in response to cognitive remediation as an augmentation of vocational rehabilitation. Schizophr Res. https://doi.org/10.1016/j.schres.2021.09.001

    Article  PubMed  Google Scholar 

  31. Browne J, Mohamed S (2022) The impact of mental health intensive case management on functioning and clinical outcomes of older Black and White veterans with serious mental illness. Am J Geriatr Psychiatry. https://doi.org/10.1016/j.jagp.2022.02.009

  32. Phillips ES, Barrio C, Brekke JS (2001) The impact of ethnicity on prospective functional outcomes from community-based psychosocial rehabilitation for persons with schizophrenia. J Community Psychol 29:657–673. https://doi.org/10.1002/jcop.1041

    Article  Google Scholar 

  33. Hall M-H, Holton KM, Öngür D, Montrose D, Keshavan MS (2019) Longitudinal trajectory of early functional recovery in patients with first episode psychosis. Schizophr Res 209:234–244. https://doi.org/10.1016/j.schres.2019.02.003

    Article  PubMed  PubMed Central  Google Scholar 

  34. Correll CU et al (2018) Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression. JAMA Psychiat 75:555–565. https://doi.org/10.1001/jamapsychiatry.2018.0623

    Article  Google Scholar 

  35. Kane JM et al (2016) Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE Early Treatment Program. Am J Psychiatry 173:362–372. https://doi.org/10.1176/appi.ajp.2015.15050632

    Article  PubMed  Google Scholar 

  36. Mueser KT et al (2015) The NAVIGATE program for first-episode psychosis: rationale, overview, and description of psychosocial components. Psychiatr Serv 66:680–690. https://doi.org/10.1176/appi.ps.201400413

    Article  PubMed  PubMed Central  Google Scholar 

  37. Browne J et al (2021) The alliance-outcome relationship in individual psychosocial treatment for schizophrenia and early psychosis: a meta-analysis. Schizophr Res 231:154–163. https://doi.org/10.1016/j.schres.2021.04.002

    Article  PubMed  Google Scholar 

  38. Browne J et al (2017) Psychological well-being and mental health recovery in the NIMH RAISE early treatment program. Schizophr Res 185:167–172. https://doi.org/10.1016/j.schres.2016.11.032

    Article  PubMed  Google Scholar 

  39. Robinson DG et al (2015) Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study. Am J Psychiatry 172:237–248. https://doi.org/10.1176/appi.ajp.2014.13101355

  40. Nagendra A et al (2018) Demographic, psychosocial, clinical, and neurocognitive baseline characteristics of Black Americans in the RAISE-ETP study. Schizophr Res 193:64–68. https://doi.org/10.1016/j.schres.2017.06.038

    Article  PubMed  Google Scholar 

  41. Puyat JH, Daw JR, Cunningham CM, Law MR, Wong ST, Greyson DL, Morgan SG (2013) Racial and ethnic disparities in the use of antipsychotic medication: A systematic review and meta- analysis. Soc Psychiatry Psychiatr Epidemiol 48:1861–1872

  42. Oluwoye O et al (2018) Racial-ethnic disparities in first-episode psychosis treatment outcomes from the RAISE-ETP study. Psychiatr Serv 69:1138–1145. https://doi.org/10.1176/appi.ps.201800067

    Article  PubMed  PubMed Central  Google Scholar 

  43. Slade M, Longden E (2015) Empirical evidence about recovery and mental health. BMC Psychiatry 15:1–14. https://doi.org/10.1186/s12888-015-0678-4

    Article  Google Scholar 

  44. Mueser KT, DeTore NR, Kredlow MA, Bourgeois ML, Penn DL, Hintz K (2020) Clinical and demographic correlates of stigma in first-episode psychosis: The impact of duration of untreated psychosis. Acta Psychiatr Scand 141:157–166. https://doi.org/10.1111/acps.13102

    CAS  Article  PubMed  Google Scholar 

  45. Corrigan PW, Druss BG, Perlick DA (2014) The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest Suppl 15:37–70. https://doi.org/10.1177/1529100614531398

    Article  Google Scholar 

  46. Corrigan PW, Rafacz J, Rüsch N (2011) Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Res 189:339–343. https://doi.org/10.1016/j.psychres.2011.05.024

    Article  PubMed  PubMed Central  Google Scholar 

  47. Taylor P, Lopez MH, Martínez JH, Velasco G (2012) When labels don’t fit: hispanics and their views of identity. Pew Research Center. https://www.pewresearch.org/hispanic/2012/04/04/when-labels-dont-fit-hispanics-and-their-views-of-identity/

  48. Heinrichs DW, Hanlon TE, Carpenter WT (1984) The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 10:388–398. https://doi.org/10.1093/schbul/10.3.388

  49. Kay SR, Fiszbein A, Opler LA (1987) The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276. https://doi.org/10.1093/schbul/13.2.261

    CAS  Article  PubMed  Google Scholar 

  50. Wallwork RS, Fortgang R, Hashimoto R, Weinberger DR, Dickinson D (2012) Searching for a consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia. Schizophr Res 137(:246–250. https://doi.org/10.1016/j.schres.2012.01.031

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  51. Addington D, Addington J, Maticka-Tyndale E (1993) Assessing depression in schizophrenia: the Calgary Depression Scale. Br J Psychiatry 163:39–44. https://doi.org/10.1192/s0007125000292581

    Article  Google Scholar 

  52. King M et al (2007) The Stigma Scale: development of a standardized measure of the stigma of mental illness. Br J Psychiatry 190:248–254. https://doi.org/10.1192/bjp.bp.106.024638

    Article  PubMed  Google Scholar 

  53. Young S, Bullock W (2003) The mental health recovery measure. University of Toledo, Toledo, OH

  54. Ryff CD (1989) Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol 57:1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069

    Article  Google Scholar 

  55. Malla A et al (2004) Determinants of quality of life in first-episode psychosis. Acta Psychiatr Scand 109:45–64. https://doi.org/10.1016/j.yebeh.2004.08.019

    Article  Google Scholar 

  56. Marino L et al (2015) The RAISE connection program for early psychosis: secondary outcomes and mediators and moderators of improvement. J Nerv Ment Dis 203:365–371. https://doi.org/10.1097/NMD.0000000000000293

    Article  PubMed  PubMed Central  Google Scholar 

  57. Schoer N, Huang CW, Anderson KK (2019) Differences in duration of untreated psychosis for racial and ethnic minority groups with first-episode psychosis: an updated systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 54:1295–1298. https://doi.org/10.1007/s00127-019-01737-3

    Article  PubMed  Google Scholar 

  58. Dominguez M-G et al (2013) Duration of untreated psychosis in adolescents: ethnic differences and clinical profiles. Schizophr Res 150:526–532. https://doi.org/10.1016/j.schres.2013.08.018

    Article  PubMed  Google Scholar 

  59. Perkins DO, Gu H, Boteva K, Lieberman JA. Reviews and overviews relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis Am J Psych 162:1785–1804. https://doi.org/10.1176/appi.ajp.162.10.1785

  60. Tandon R, Nasrallah HA, Keshavan MS (2009) Schizophrenia, ‘just the facts’ 4. Clinical features and conceptualization. Schizophr Res 110:1–23. https://doi.org/10.1016/j.schres.2009.03.005

    Article  PubMed  Google Scholar 

  61. Bennett D, Rosenheck R (2021) Socioeconomic status and the effectiveness of treatment for first-episode psychosis. Health Serv Res. 56:409-417. https://doi.org/10.1111/1475-6773.13606

    Article  PubMed  Google Scholar 

  62. Lee RT, Perez AD, Malik-Boykin C, Mendoza-Denton R (2019) On the prevalence of racial discrimination in the United States. PLoS ONE 14:1–16. https://doi.org/10.1371/journal.pone.0210698

    CAS  Article  Google Scholar 

  63. Schulze B (2007) Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry 19:137–155. https://doi.org/10.1080/09540260701278929

    Article  PubMed  Google Scholar 

  64. Das-Munshi J, Stewart R, Morgan C, Nazroo J, Thornicroft G, Prince M (2016) Reviving the ‘double jeopardy’ hypothesis: physical health inequalities, ethnicity and severe mental illness. Br J Psychiatry 209:183–185. https://doi.org/10.1192/bjp.bp.114.159210

    Article  PubMed  Google Scholar 

  65. Gaston GB, Earl TR, Nisanci A, Glomb B (2016) Perception of mental health services among Black Americans. Soc Work Ment Health 14:676–695. https://doi.org/10.1080/15332985.2015.1137257

    Article  Google Scholar 

  66. Parcesepe AM, Cabassa LJ (2013) Public stigma of mental illness in the United States: a systematic literature review. Adm Policy Ment Health Men Health Serv Res 40:384–399. https://doi.org/10.1007/s10488-012-0430-z

    Article  Google Scholar 

  67. Mays VM, Jones AL, Delany-Brumsey A, Coles C, Cochran SD (2017) Perceived discrimination in health care and mental health/substance abuse treatment among Blacks, Latinos, and Whites. Med Care 55:173–181. https://doi.org/10.1097/MLR.0000000000000638

    Article  PubMed  PubMed Central  Google Scholar 

  68. Meyer PS, Gottlieb JD, Penn D, Mueser K, Gingerich S (2015) Individual resiliency training: an early intervention approach to enhance well-being in people with first-episode psychosis. Psychiatr Ann 45:554–560. https://doi.org/10.3928/00485713-20151103-06

    Article  Google Scholar 

  69. Danice L, Brown Tracy L, Tylka (2011) Racial discrimination and resilience in African American young adults: examining racial socialization as a moderator. J Black Psychol 37(3):259–285. https://doi.org/10.1177/0095798410390689

  70. Karlsen S, Nazroo JY, McKenzie K, Bhui K, Weich S (2005) Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychol Med 35:1795–1803. https://doi.org/10.1017/S0033291705005830

    Article  PubMed  Google Scholar 

  71. Veling W, Susser E, Van Os J, Mackenbach JP, Selten JP, Hoek HW (2008) Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants. Am J Psychiatry 165:66–73. https://doi.org/10.1176/appi.ajp.2007.07030423

    Article  PubMed  Google Scholar 

  72. Veling W, Selten JP, Susser E, Laan W, Mackenbach JP, Hoek HW (2007) Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands. Int J Epidemiol 36:761–768. https://doi.org/10.1093/ije/dym085

    Article  PubMed  Google Scholar 

  73. Anglin DM, Lui F, Espinosa A, Tikhonov A, Ellman L (2018) Ethnic identity, racial discrimination and attenuated psychotic symptoms in an urban population of emerging adults. Early Interv Psychiatry 12:380–390. https://doi.org/10.1111/eip.12314

    Article  PubMed  Google Scholar 

  74. Oh H, Jacob L, Anglin DM, Koyanagi A (2021) Perceived skin tone discrimination and psychotic experiences among Black Americans: Findings from the National Survey of American Life. Schizophr Res 228:541–546. https://doi.org/10.1016/j.schres.2020.11.033

    Article  PubMed  Google Scholar 

  75. Whaley AL (2001) Cultural mistrust: an important psychological construct for diagnosis and treatment of African Americans. Prof Psychol Res Pract 32:555–562. https://doi.org/10.1037//0735-7028.32.6.555

    Article  Google Scholar 

  76. Whaley AL (2002) Confluent paranoia in African American psychiatric patients: an empirical study of Ridley’s typology. J Abnorm Psychol 111:568–577. https://doi.org/10.1037//0021-843X.111.4.568

    Article  PubMed  Google Scholar 

  77. Iwata N, Turner RJ, Lloyd DA (2002) Race and ethnicity and depressive symptoms in community-dwelling young adults: A differential item functioning analysis. Psychiatry Res 110:281–289. https://doi.org/10.1016/S0165-1781(02)00102-6

    Article  PubMed  Google Scholar 

  78. Perreira KM, Deeb-Sossa N, Harris KM, Bollen K (2005) What are we measuring? an evaluation of the CES-D across race/ethnicity and immigrant generation. Soc Forces 83:1567–1601. https://doi.org/10.1353/sof.2005.0077

    Article  Google Scholar 

  79. Pinkham AE, Kelsven S, Kouros C, Harvey PD, Penn DL (2017) The effect of age, race, and sex on social cognitive performance in individuals with schizophrenia. J Nerv Ment Dis 205:346–352. https://doi.org/10.1097/NMD.0000000000000654

    Article  PubMed  PubMed Central  Google Scholar 

  80. Reed TD, Neville HA (2014) The influence of religiosity and spirituality on psychological well-being Among Black women. J Black Psychol 40:384–401. https://doi.org/10.1177/0095798413490956

    Article  Google Scholar 

  81. Nguyen AW (2020) Religion and mental health in racial and ethnic minority populations: a review of the literature. Innov Aging 4:1–13. https://doi.org/10.1093/geroni/igaa035

    Article  Google Scholar 

  82. Weisman de Mamani AG, Tuchman N, Duarte EA (2010) Incorporating religion/spirituality into treatment for serious mental illness. Cogn Behav Pract 17:348–357. https://doi.org/10.1016/j.cbpra.2009.05.003

    Article  Google Scholar 

  83. Cabral RR, Smith TB (2011) Racial/ethnic matching of clients and therapists in mental health services: a meta-analytic review of preferences, perceptions, and outcomes. 58:537–554, https://doi.org/10.1037/a0025266.

  84. Chinman MJ, Rosenheck RA, Lam JA (2000) Client-case manager racial matching in a program for homeless persons with serious mental illness. Psychiatr Serv 51:1265–1272. https://doi.org/10.1176/appi.ps.51.10.1265

    CAS  Article  PubMed  Google Scholar 

Download references

Funding

This secondary data analysis used data from the RAISE-Early Treatment program study, which was supported in whole or in part with funds from the American Recovery and Reinvestment Act and the National Institute of Mental Health (HHSN-271-2009-00019C). Additional support was provided by the National Institute of Mental Health Advanced Centers for Intervention and/or Services Research award (P30MH090590) to Dr. John Kane.

Author information

Author notes

  1. Kim T. Mueser and David L. Penn shared last authorship.

Authors and Affiliations

  1. Center of Excellence in Psychosocial and Systemic Research, Massachusetts General Hospital, Boston, MA, USA

    Arundati Nagendra & Corinne Cather

  2. Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Arundati Nagendra, Carrington Merritt, Effua E. Sosoo & David L. Penn

  3. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Arundati Nagendra & Corinne Cather

  4. Center for Psychiatric Research, Maine Medical Center Research Institute, Portland, ME, USA

    David M. Weiss

  5. Center for Psychiatric Rehabilitation, Departments of Occupational Therapy and Psychological and Brain Sciences, Boston University, Boston, MA, USA

    Kim T. Mueser

  6. School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia

    David L. Penn

  7. Durham Veterans Affairs Health Care System, Durham, NC, USA

    Effua E. Sosoo

Authors
  1. Arundati Nagendra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David M. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carrington Merritt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Corinne Cather
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Effua E. Sosoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kim T. Mueser
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David L. Penn
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AN conceptualized and wrote the first draft of the paper. DMW conducted statistical analyses. The other authors provided substantive feedback, edits, and revisions to the manuscript.

Corresponding author

Correspondence to Arundati Nagendra.

Ethics declarations

Conflict of interest

All authors declare no conflicts of interest pertinent to this study.

Ethics approval (include appropriate approvals or waivers)

N/A, secondary data analysis.

Consent to participate (include appropriate statements)

N/A, secondary data analysis.

Consent for publication (include appropriate statements)

N/A, secondary data analysis.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 66 KB)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nagendra, A., Weiss, D.M., Merritt, C. et al. Clinical and psychosocial outcomes of Black Americans in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study. Soc Psychiatry Psychiatr Epidemiol (2022). https://doi.org/10.1007/s00127-022-02297-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00127-022-02297-9

Keywords

  • Schizophrenia
  • First-episode psychosis
  • Racial disparities
  • Black mental health
  • Treatment outcomes