Recent research published in Health and Place (Ngamini Ngui et al., 2013b) found that one third of people with first episode psychosis [FEP] will have made a large-scale migration six years after initial diagnosis. Here, I extend this discussion around three important observations. Namely, at first presentation the most disadvantaged communities already shoulder the burden of psychotic morbidity; people with FEP in more rural communities migrate less often, and people with FEP exhibit both upwards and downwards social mobility after onset. Understanding the reasons for (non-)migration before and after psychosis onset is now required for effective public mental health and service provision. © 2014 The Author.

Social determinants Migration Social drift schizophrenia Public mental health

urban population urban area rural area mental health service schizophrenia mental health human psychosis Sociological Factors social aspects and related phenomena rural population priority journal morbidity social support social mobility mental health care Humans psychology Canada environmental factor Socioeconomic Factors Psychotic Disorders socioeconomics health services prevalence Incidence Article service provision migration foster care Transients and Migrants social class onset age health care disparity public health