Using Critical Race Theory to guide quality improvement in a specialty outpatient program for first break psychosis Public Deposited

Racial disparities have existed in mental healthcare for too long without meaningful improvement. These disparities are at least partially related to the disregard for patient experiences unique to those who identify as young, and Black, Indigenous and People of Color (BIPOC), and who are systematically left out of patient feedback processes. Critical Race Theory suggests racism is ordinary, and the unique experiences of BIPOC-identifying patients are valuable and should guide quality improvement in the mental healthcare sector. The site for this project was an two-year, outpatient treatment program (“program”) for youth experiencing their first episode of psychosis in the Pacific Northwest. This project aimed to center the experiences of the program’s BIPOC clientele in future quality improvement projects by capturing their experiences and satisfaction of services via survey. The project team reached out to clients by phone and text over a four-month period, aiming for a 50% response rate. Clients filled out a survey independently or participated in a semi-structured phone interview. Response rates and quantity of feedback improved with text/phone outreach, and via phone interviews. Thematic analysis revealed a diversity of perspectives on how program staff engage clients around their racialized identity, and the salience of one’s racial identity to the provision of services. Overall, patient feedback surveys did lead to valuable data on BIPOC patient experiences within the program, but surveys may unintentionally limit feedback and communicate unexamined assumptions.


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  • https://doi.org/10.6083/p2676w16q
  • Wright.Leslie.2022.pdf
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Publication Date
  • 2022
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