Preventing Homelessness among Persons Diagnosed with Schizophrenia

To what extent psychiatric intervention at the first episode of psychosis predicts long-term outcome, remains an open question. Much research has been done on patient variables and duration of untreated psychosis as predictive factors, but considerably less attention has been paid to the interaction between individual, interventional and social variables at this important juncture. Homelessness, whether occurring early or later in the course of illness, is one important element of poor social outcomes, as are relapse, re-hospitalization, long-term institutionalization and social exclusion/marginalization. There are some intriguing indicators, mostly hidden in the vast literature on schizophrenia, that suggest pre-morbid and early social/familial factors may have an important bearing on positive and negative outcomes. The question whether different types of interventions at the onset of flagrant psychosis, especially when focused on individual and family dynamics, could have a favorable impact on long-term outcome, including on the prevention of homelessness and institutionalization, is still relevant. This is especially important at a time when renewed attention is being paid to the optimal treatment of first episode psychosis. This talk will review several studies that suggest family involvement and ongoing support may be a key variable in promoting early recovery, sustaining positive family ties, maximizing optimal use of antipsychotic medications, and averting negative social outcomes, and will also address some of the questions that remain open.

Peter Stastny, MD graduated from medical school in Vienna, Austria in 1976. Since 1978 he has been working and residing in New York City. He is a Senior Psychiatrist, ACT Team, Bronx Psychiatric Center, a Consulting Psychiatrist, Community Access, Inc., a Psychiatrist, South Beach Psychiatric Center, and a Founding Member, International Network Toward Alternatives for Recovery (INTAR). He has conducted several publically-funded research projects in the area of vocational rehabilitation, social support and self-help, in collaboration with individuals who had survived personal crises and psychiatric interventions. Currently, Dr. Stastny is working on the development of alternative services that obviate psychiatric intervention and offer autonomous paths towards recovery and full integration. These activities have engendered a close collaboration with the user-survivor movement, as manifested by joint research projects, publications, service demonstrations, and community work.

PDF of Powerpoint Presentation: Introducing Alternative Treatment at First Break