178.4 Psychosis Literacy of US Latinos: A Community, Clinical, and Caregiver Comparison

Background: We compare the psychosis literacy of 3 samples of Latinos residing in Los Angeles County: persons with first episode of psychosis (FEP), their caregivers, and community residents. Methods: Individuals with FEP (n = 71) and their caregivers (n = 59) were recruited as part of a 2-year ongoing assessment of the duration of untreated psychosis. Community residents (n = 498) were obtained through a randomized household survey. Psychosis literacy was defined as (a) knowledge of psychosis (delusions, disorganized speech, and hallucinations), (b) attributions to psychosis in a hypothetical case, and (c) recommendations that professional help be sought for the case. To assess knowledge, all participants were asked “What is serious mental illness?” and their responses were coded as reflecting 0 to 3 psychotic symptoms. To assess attributions to psychosis and professional help seeking, all participants were presented with a 4-minute videotaped narrative of an actress relating a story about her neighbor who experiences psychotic symptoms embedded in multiple life problems. Participants were asked to describe the presenting problem (attributions to psychosis—yes or no) and what the parents should do (professional help-seeking—yes or no). The interrater reliability of coding of responses to open-ended questions was very good ICCs (.79–1.0). Results: Ill relatives (M = 0.69 symptoms, SD = 0.75) and community residents (M = 0.61 symptoms, SD = 0.90) reported little knowledge of psychosis whereas caregivers reported a significantly greater degree of psychosis knowledge (M = 1.36 symptoms, SD = 0.84, P s < .001). Persons with FEP reported the lowest degree of psychosis attribution (24%), which was significantly lower than community residents (M = 37%, P = .04) and caregivers (46%, P = .015). Ill relatives (36%) had the lowest professional referral rate compared to over half (57%) of the community residents and over two-thirds (69%) of caregivers ( P s < .01). Conclusion: Persons with FEP have the lowest level of psychosis literacy. In the key indicators, individuals with FEP have nearly half the level of psychosis literacy as their caregivers. The fact that psychosis literacy for ill relatives is lower than that of community residents suggests that they actively seek not to consider psychosis in the hypothetical individual with psychosis. In addition, they give little consideration to the case’s need for professional help. Given that this active effort may ser