Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support

TL;DR

This study identifies unmet needs among young adults with first-episode psychosis in South Africa and explores the potential of basic income support as an intervention.

Contribution

The study quantifies unmet needs in FEP young adults and introduces a pilot trial of basic income support in a resource-limited setting.

Findings

The most severe unmet need was the inability to access government benefits.

Most participants reported their need for managing psychotic symptoms was met or partially met.

Integrated interventions are needed to address broader youth needs beyond symptom management.

Abstract

People with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa.

This study quantifies the needs among unemployed FEP adults aged 18–29 years in South Africa for potential early intervention targeting.

The study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa.

As part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs.

Most participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (interquartile range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met.

The needs of youth must go beyond the temporary management of psychotic symptoms.

This study highlights the unmet needs of young adults with FEP in resource-constrained environments and underscores the need for integrated interventions.