IJPDS International Journal of Population Data Science

A first diagnosis of a psychotic disorder is an overwhelming experience for an individual. It is also associated with a high mortality rate among young people. The best outcomes are achieved when individuals can access high quality care early after illness onset, but unfortunately, this does not happen for up to half of all incident cases.

In a new study from ICES, published in the International Journal of Population Data Science (IJPDS), more than 44,000 Ontarians diagnosed with psychosis between 2017-2021 were tracked to offer insight into how and where mental health services can be enhanced across the province.

To better understand the current landscape of psychosis in Ontario, Canada’s most populous province, the study team analysed hospital and physician billing records alongside demographic data, such as age, sex and income status, to answer two key questions:

1. Where are people being diagnosed, and
2. What health services are they using in the year following their psychosis diagnosis?

The findings point to many opportunities for improving care. The number of psychosis cases varied across different regions in Ontario, with cases being relatively higher in the Northern areas, including more frequent mental health-related hospital visits. Access to psychiatrists was highest in Toronto, Ontario’s most urban region, but less common in Northern regions.

The results provide valuable insight into the current state of early psychosis care in Ontario and will help to align resources with regional requirements for services. The study highlights the need for more psychosis care in Northern areas, including access to psychiatrists and family physicians to help reduce the burden on hospitals. Strategies should include establishing health centres with inter-professional teams, implementing telemedicine or mobile clinics in remote areas, and providing education and training to retain Northern-born professionals.

This study can, of course, be replicated in other jurisdictions, ultimately promoting the use of evidence-based decision making for psychosis-related policy. Dr. Paul Kurdyak, the study’s senior author said “This study provides Ontario with policy-relevant evidence and an opportunity to align resources based on measured population-based need for individuals experiencing their first psychotic episode. This is an important first step in addressing the mental health needs of Ontarians with a first diagnosis of a psychotic illness.”

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Co-authors Amreen Babujee, Isobel Sharpe, and Paul Kurdyak along with their Mental Health and Addictions Program research team at ICES in Toronto, Ontario