Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis

2018 ◽  
Vol 46 (3) ◽  
pp. 415-433
Author(s):  
Jane E. Hamilton ◽  
Devika Srivastava ◽  
Danica Womack ◽  
Ashlie Brown ◽  
Brian Schulz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
Treatment Retention ◽  
First Episode ◽  
Episode Psychosis

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

scholarly journals A Digital Health Innovation to Prevent Relapse and Support Recovery in Youth Receiving Specialized Services for First-Episode Psychosis: Protocol for a Pilot Pre-Post, Mixed Methods Study of Horyzons-Canada (Phase 2) (Preprint)

2021 ◽  
Author(s):  
Shalini Lal ◽  
John F Gleeson ◽  
Simon D'Alfonso ◽  
Geraldine Etienne ◽  
Ridha Joober ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Digital Health ◽  
First Episode Psychosis ◽  
Funding Agency ◽  
First Episode ◽  
Health Innovation ◽  
Potential Efficacy ◽  
Episode Psychosis ◽  
Support Recovery

BACKGROUND Psychotic disorders are among the most disabling of all mental disorders. The first-episode psychosis (FEP) often occurs during adolescence or young adulthood. Young people experiencing FEP often face multiple barriers in accessing a comprehensive range of psychosocial services, which have predominantly been delivered in person. New models of service delivery that are accessible, sustainable, and engaging are needed to support recovery in youth diagnosed with FEP. OBJECTIVE In this paper, we describe a protocol to implement and evaluate the acceptability, safety, and potential efficacy of an online psychosocial therapeutic intervention designed to sustain recovery and prevent relapses in young adults diagnosed with FEP. This intervention was originally developed and tested in Australia and has been adapted for implementation and evaluation in Canada and is called Horyzons-Canada (HoryzonsCa). METHODS This cohort study is implemented in a single-center and applies a pre-post mixed methods (qualitative-quantitative convergent) design. The study involves recruiting 20 participants from a specialized early intervention program for psychosis located in Montreal, Canada and providing them with access to the HoryzonsCa intervention for 8 weeks. Data collection includes interview-based psychometric measures, self-reports, focus groups, and interviews. RESULTS This study received funding from the Brain and Behavior Research Foundation (United States), the Quebec Health Research Funding Agency (Canada), and the Canada Research Chairs Program. The study was approved by the Research Ethics Board of the Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l'Île-de-Montréal on April 11, 2018 (#IUSMD 17-54). Data were collected from August 16, 2018, to April 29, 2019, and a final sample of 20 individuals participated in the baseline and follow-up interviews, among which 9 participated in the focus groups. Data analysis and reporting are in process. The results of the study will be submitted for publication in 2021. CONCLUSIONS This study will provide preliminary evidence on the acceptability, safety, and potential efficacy of using a digital health innovation adapted for the Canadian context to deliver specialized mental health services to youth diagnosed with FEP. CLINICALTRIAL ISRCTN Registry ISRCTN43182105; https://www.isrctn.com/ISRCTN43182105 INTERNATIONAL REGISTERED REPORT RR1-10.2196/28141

scholarly journals Understanding differences in family engagement and provider outreach in New Journeys: A coordinated specialty care program for first episode psychosis

2020 ◽  
Vol 291 ◽  
pp. 113286 ◽  
Author(s):  
Oladunni Oluwoye ◽  
Bryony Stokes ◽  
Bryan Stiles ◽  
Maria Monroe-DeVita ◽  
Michael G. McDonell
Keyword(s):  
Family Engagement ◽  
Care Program ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Episode Psychosis

scholarly journals F130. SAMHSA SUPPORTED COORDINATED SPECIALTY CARE FOR FIRST-EPISODE PSYCHOSIS: THE PENN PSYCHOSIS EVALUATION AND RECOVERY CENTER (PERC)

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S303-S303
Author(s):  
Monica Calkins ◽  
Lyndsay Schmidt ◽  
LaTonya McCurry ◽  
Bridgette Patton ◽  
Sunny Tang ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Episode Psychosis

First-Person Accounts of Change Among Young Adults Enrolled in Coordinated Specialty Care for First-Episode Psychosis

2020 ◽  
Vol 71 (12) ◽  
pp. 1277-1284
Author(s):  
Tamara C. Daley ◽  
Nev Jones ◽  
Preethy George ◽  
Abram Rosenblatt
Keyword(s):  
Young Adults ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
First Person ◽  
Episode Psychosis

scholarly journals S132. MEASUREMENT-BASED CARE IN WASHINGTON STATE’S COORDINATED SPECIALTY CARE PROGRAM FOR FIRST EPISODE PSYCHOSIS

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S357-S357
Author(s):  
Oladunni Oluwoye ◽  
Bryony Stokes ◽  
Elizabeth Ventuo ◽  
Todd Blair ◽  
Bradley Cotter ◽  
...  
Keyword(s):  
Care Program ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Measurement Based Care ◽  
Episode Psychosis

scholarly journals Developing and implementing a culturally informed FAmily Motivational Engagement Strategy (FAMES) to increase family engagement in first episode psychosis programs: mixed methods pilot study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036907
Author(s):  
Oladunni Oluwoye ◽  
Dennis Dyck ◽  
Sterling M McPherson ◽  
Roberto Lewis-Fernández ◽  
Michael T Compton ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Advisory Committee ◽  
Phase 1 ◽  
Intervention Mapping ◽  
Family Members ◽  
First Episode Psychosis ◽  
First Episode ◽  
Culturally Informed ◽  
Episode Psychosis

IntroductionDespite the proven effectiveness of coordinated specialty care (CSC) programmes for first episode psychosis in the USA, CSC programmes often have low levels of engagement in family psychoeducation, and engagement of racial and ethnic minority family members is even lower than that for non-Latino white family members. The goal of this study is to develop and evaluate a culturally informed FAmily Motivational Engagement Strategy (FAMES) and implementation toolkit for CSC providers.Methods and analysisThis protocol describes a mixed methods, multi-phase study that blends intervention mapping and the Promoting Action on Research in Health Services framework to develop, modify and pilot-test FAMES and an accompanying implementation toolkit. Phase 1 will convene a Stakeholder Advisory Committee to inform modifications based on findings from phases 1 and 2. During phase 1, we will also recruit approximately 200 family members to complete an online survey to assess barriers and motivation to engage in treatment. Phase 2 we will recruit five family members into a 3-month trial of the modified FAMES and implementation toolkit. Results will guide the advisory committee in refining the intervention and implementation toolkit. Phase 3 will involve a 16-month non-randomised, stepped-wedge trial with 50 family members from five CSC programmes in community-based mental health clinics to examine the acceptability, feasibility and initial impact of FAMES and the implementation toolkit.Ethics and disseminationThis study received Institutional Review Board approval from Washington State University, protocol #17 812–001. Results will be disseminated via peer review publications, presentations at national and international conferences, and to local community mental health agencies and committees.Trial registration numberClinicalTrials.gov Registry (NCT04188366).

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