Impact of Treatment Initiation and Engagement on Deliberate Self-Harm Among Individuals With First-Episode Psychosis

OBJECTIVE: Individuals with psychosis are at increased risk for suicide, with the greatest risk being present during the first few months after diagnosis. The authors aimed to examine whether treatment initiation within 14 days of diagnosis and treatment engagement within 90 days of initiation reduce the risk for deliberate self-harm (DSH) among individuals with first-episode psychosis (FEP). METHODS: A retrospective longitudinal cohort design was adopted by using Ohio Medicaid claims for 6,349 adolescents and young adults ages 15-24 years with FEP. Logistic regression was used to examine factors associated with treatment initiation and engagement. Cox proportional hazard models were used to estimate the impact of treatment initiation and engagement on DSH. Propensity score weighting was used to control for sociodemographic and clinical covariates. RESULTS: Approximately 70% of the sample initiated treatment, 55% of whom engaged in treatment. Treatment initiation and engagement were associated with both demographic and clinical variables. Treatment initiation significantly reduced the hazard of DSH (average treatment effect in the entire population: hazard ratio [HR]=0.62, 95% CI=0.47-0.81; average treatment effect among those treated: HR=0.64, 95% CI=0.52-0.80). In contrast, treatment engagement was not significantly associated with DSH. CONCLUSIONS: These results suggest that the initial treatment contact is essential for reducing DSH among adolescents and young adults with FEP. Additionally, the finding that treatment engagement did not reduce DSH suggests that standard clinical care may not be sufficient for reducing DSH in this population. These findings highlight the need for suicide-specific interventions for individuals with FEP

It's my life: Evaluation report

This report presents a snapshot of some outcomes from the by-youth for-youth It's My Life youth smokefree research project, which was funded by the Pathway to Smokefree New Zealand 2025 Innovation Fund. The report includes quantitative data from the It’s My Life pre and post evaluation surveys, campus cessation reporting, and social media analytics, plus qualitative data from youth participants in the project. Two key results from the Massey University surveys are that over the It’s My Life campaign timeframe, smokers’ desire to quit increased and tolerance of the tobacco industry, in general but also particularly among smokers, reduced. We interpret these results as an endorsement of the decision by the young people who designed the campaign not to vilify smokers but to use positive empowerment themes to make smokers feel supported and encouraged to take back control of their lives from tobacco companies.falseMinistry of Healt