A Stitch in Time: Early Psychosis Intervention

August 2019

This month’s collection explores interventions for people with early psychosis and those at clinical high risk for psychosis. The interventions seek to improve outcomes through a range of evidence-based pharmacologic, psychotherapeutic, and psychosocial methods. Early intervention has received increasing attention and support over the past decade, particularly with the NIMH-funded RAISE (Recovery After an Initial Schizophrenia Episode) project and targeted funding through community mental health block grants. The following articles describe innovations in screening, engagement, and treatment. These include a description of the Early Detection, Intervention and Prevention of Psychosis Program, reports from coordinated specialty care across the United States with examples from California to OnTrackNY, use of Internet-based advertising for patient engagement, and NYC START’s efforts to enhance hospital-to-community transitions. These efforts to improve mental health outcomes and quality of life for people with early psychosis or at clinical high risk of developing psychosis target previously missed opportunities by offering timely, evidence-based approaches.

Carrie Cunningham, M.D., M.P.H.
Lisa B. Dixon, M.D., M.P.H.

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Treatment Target

Duration of Untreated Psychosis in Community Treatment Settings in the United States
Jean Addington, Ph.D., Robert K. Heinssen, Ph.D., Delbert G. Robinson, M.D., Nina R. Schooler, Ph.D., Patricia Marcy, B.S.N., Mary F. Brunette, M.D., Christoph U. Correll, M.D., Sue Estroff, Ph.D., Kim T. Mueser, Ph.D., David Penn, Ph.D., James A. Robinson, M.Ed., Robert A. Rosenheck, M.D., Susan T. Azrin, Ph.D., Amy B. Goldstein, Ph.D., Joanne Severe, M.S., John M. Kane, M.D.
2015, Volume 66, Issue 7, pp. 753–756

Screening

Evidence for Differential Predictive Performance of the Prime Screen Between Black and White Help-Seeking Youths
Zachary B. Millman, M.A., Pamela J. Rakhshan Rouhakhtar, M.A., Jordan E. DeVylder, Ph.D., Melissa E. Smith, Ph.D., Peter L. Phalen, Psy.D., Scott W. Woods, M.D., Barbara C. Walsh, Ph.D., Brittany Parham, Ph.D., Gloria M. Reeves, M.D., Jason Schiffman, Ph.D.
2019, Volume 70, Issue 10, pp. 907–914

Also featured in the Racial-Ethnic Disparities in Mental Health Care collection.

Acceptability of Psychosis Screening and Factors Affecting Its Implementation: Interviews With Community Health Care Providers
Mark Savill, Ph.D., Haley V. Skymba, B.S., J. Daniel Ragland, Ph.D., Tara Niendam, Ph.D., Rachel L. Loewy, Ph.D., Tyler A. Lesh, Ph.D., Cameron Carter, M.D., Howard H. Goldman, M.D., Ph.D.
2018, Volume 69, Issue 6, pp. 689–695


Is the Clinical High-Risk State a Valid Concept? Retrospective Examination in a First-Episode Psychosis Sample
Jai L. Shah, M.D., F.R.C.P.C., Anne Crawford, M.D., F.R.C.P.C., Sally S. Mustafa, Ph.D., Srividya N. Iyer, Ph.D., Ridha Joober, M.D., Ph.D., Ashok K. Malla, M.B.B.S., F.R.C.P.C.
2017, Volume 68, Issue 10, pp. 1046–1052

Treatment Engagement

Using Digital Media Advertising in Early Psychosis Intervention
Michael L. Birnbaum, M.D., Chantel Garrett, B.S., Amit Baumel, Ph.D., Maria Scovel, Asra F. Rizvi, M.A., Whitney Muscat, B.S., John M. Kane, M.D.
2017, Volume 68, Issue 11, pp. 1144–1149


Decision Making About Pathways Through Care for Racially and Ethnically Diverse Young Adults With Early Psychosis
Neely Myers, Ph.D., Anubha Sood, Ph.D., Katherine E. Fox, M.A., Gillian Wright, B.S., Michael T. Compton, M.D., M.P.H.
2019, Volume 70, Issue 3, pp. 184–190

RAISE

Racial-Ethnic Disparities in First-Episode Psychosis Treatment Outcomes From the RAISE-ETP Study
Oladunni Oluwoye, Ph.D., C.H.E.S., Bryan Stiles, B.A., Maria Monroe-DeVita, Ph.D., Lydia Chwastiak, M.D., M.P.H., Jon M. McClellan, M.D., Dennis Dyck, Ph.D., Leopoldo J. Cabassa, Ph.D., M.S.W., Michael G. McDonell, Ph.D.
2018, Volume 69, Issue 11, pp. 1138–1145


Predictors of Hospitalization of Individuals With First-Episode Psychosis: Data From a 2-Year Follow-Up of the RAISE-ETP
Delbert G. Robinson, M.D., Nina R. Schooler, Ph.D., Robert A. Rosenheck, M.D., Haiqun Lin, M.D., Ph.D., Kyaw J. Sint, Ph.D., Patricia Marcy, B.S.N., John M. Kane, M.D.
2019, Volume 70, Issue 7, pp. 569–577


Family Involvement in the Clinical Care of Clients With First-Episode Psychosis in the RAISE Connection Program
Amy L. Drapalski, Ph.D., Sarah Piscitelli, M.A., Rufina J. Lee, M.S.W., Deborah Medoff, Ph.D., Lisa B. Dixon, M.D., M.P.H.
2018, Volume 69, Issue 3, pp. 358–361

Also featured in Family Members and Caregivers collection.

Specific Programs

First-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial
Vinod H. Srihari, M.D., Cenk Tek, M.D., Suat Kucukgoncu, M.D., Vivek H. Phutane, M.D., Nicholas J. K. Breitborde, Ph.D., Jessica Pollard, Ph.D., Banu Ozkan, M.D., John Saksa, Psy.D., Barbara C. Walsh, Ph.D., Scott W. Woods, M.D.
2015, Volume 66, Issue 7, pp. 705–712


Results of a Coordinated Specialty Care Program for Early Psychosis and Predictors of Outcomes
Ilana Nossel, M.D., Melanie M. Wall, Ph.D., Jennifer Scodes, M.S., Leslie A. Marino, M.D., M.P.H., Sacha Zilkha, Ph.D., Iruma Bello, Ph.D., Igor Malinovsky, Psy.D., Rufina Lee, Ph.D., Marleen Radigan, Dr.P.H., Thomas E. Smith, M.D., Lloyd Sederer, M.D., Gyojeong Gu, M.P.P., Lisa Dixon, M.D., M.P.H.
2018, Volume 69, Issue 8, pp. 863–870


The Rise of Early Psychosis Care in California: An Overview of Community and University-Based Services
Tara A. Niendam, Ph.D., Angela Sardo, B.A., Mark Savill, Ph.D., Pooja Patel, B.S., Guibo Xing, Ph.D., Rachel L. Loewy, Ph.D., Carolyn S. Dewa, M.P.H., Ph.D., Joy Melnikow, M.D., M.P.H.
2019, Volume 70, Issue 6, pp. 480–487


Early Detection, Intervention and Prevention of Psychosis Program: Community Outreach and Early Identification at Six U.S. Sites
Sarah Lynch, L.C.S.W., William R. McFarlane, M.D., Brenda Joly, Ph.D., Steven Adelsheim, M.D., Andrea Auther, Ph.D., Barbara A. Cornblatt, Ph.D., M.B.A., Margaret Migliorati, L.P.C.C., J. Daniel Ragland, Ph.D., Tamara Sale, M.A., Elizabeth Spring, R.N., Roderick Calkins, Ph.D., Cameron S. Carter, M.D., Rebecca Jaynes, L.C.P.C., Stephan F. Taylor, M.D., Donna Downing, M.S., O.T.R.L.
2016, Volume 67, Issue 5, pp. 510–516

Connection to Treatment

NYC START: A New Model for Securing Community Services for Individuals Hospitalized for First-Episode Psychosis
Daniel Anderson, M.S.W., Tsering Choden, M.P.H., Tracy Sandseth, M.S.W., Tricia Teoh, M.D., M.P.H., Susan M. Essock, Ph.D., Myla E. Harrison, M.D., M.P.H.
2019, Volume 70, Issue 8, pp. 644–649

Special Topics

Recommendations and Challenges of the Clinical Services Panel of the PhenX Early Psychosis Working Group
Lisa Dixon, M.D., M.P.H., Nev Jones, Ph.D., Rachel Loewy, Ph.D., Diana Perkins, M.D., M.P.H., Tamara Sale, M.A., Wayne Huggins, Ph.D., Carol Hamilton, Ph.D.
2019, Volume 70, Issue 6, pp. 514–517


Estimated Staff Time Effort, Costs, and Medicaid Revenues for Coordinated Specialty Care Clinics Serving Clients With First-Episode Psychosis
Thomas E. Smith, M.D., Margaret Kurk, M.S., Rishi Sawhney, M.D., Yuhua Bao, Ph.D., Ilana Nossel, M.D., Dana E. Cohen, M.P.A., Lisa B. Dixon, M.D., M.P.H.
2019, Volume 70, Issue 5, pp. 425–427


Caught in the “NEET Trap”: The Intersection Between Vocational Inactivity and Disengagement From an Early Intervention Service for Psychosis
Anika Maraj, M.D., Sally Mustafa, Ph.D., Ridha Joober, M.D., Ph.D., Ashok Malla, M.B.B.S., F.R.C.P.C., Jai L. Shah, M.D., F.R.C.P.C., Srividya N. Iyer, Ph.D.
2019, Volume 70, Issue 4, pp. 302–308


Adapting Open Dialogue for Early-Onset Psychosis Into the U.S. Health Care Environment: A Feasibility Study
Christopher Gordon, M.D., Vasudha Gidugu, M.A., E. Sally Rogers, Sc.D., John DeRonck, L.I.C.S.W., Douglas Ziedonis, M.D., M.P.H.
2016, Volume 67, Issue 11, pp. 1166–1168

Criminal Justice System

First-Episode Psychosis and the Criminal Justice System: Using a Sequential Intercept Framework to Highlight Risks and Opportunities
Tobias Wasser, M.D., Jessica Pollard, Ph.D., Deborah Fisk, L.C.S.W., Ph.D., Vinod Srihari, M.D.
2017, Volume 68, Issue 10, pp. 994–996

Also featured in Mental Health Criminal Justice Diversion collection.

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