In what is sure to become a seminal study in the field of early intervention for psychosis, Kane et al. (2015) have published a study on the implementation of a multidisciplinary, team-based, comprehensive care model for the treatment of first-episode psychosis in community care settings. The Early Treatment Program (ETP) is part of the National Institute of Mental Health’s (NIMH) Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE). The treatment approach, called NAVIGATE, includes personalized medication management, family psychoeducation, resilience-focused individual therapy, and supported employment and education.
 
Study participants were 15-40 years old and diagnosed with schizophrenia, schizoaffective disorder, schizophreniform disorder, psychotic disorder not otherwise specified, or brief psychotic disorder according to DSM-IV and no more than 6 months of treatment with antipsychotic medications. Participants received treatment for a minimum of 2 years at any one of 34 clinical sites in 21 states.
 
The results of the study show that participants in the treatment condition experienced greater improvement both clinican and functional outcomes including quality of life, psychopathology, and greater involvement in work and school as compared to participants receiving usual community care (treatment determined by clinician and availability of services).

Results support the case for implementation in U.S. community care settings that wish to offer specialty services for early intervention for psychosis. For a detailed summary of the structure of the NAVIGATE program, please refer to Mueser et al. (2015).

References:
Bertolote J, McGorry P: Early intervention and recovery for young people with early psychosis: consensus statement. Br J Psychiatry Suppl 2005; 48:s116–s119

Kane, J.M., Robinson, D.G., Schooler, N.R., Mueser, K.T., Penn, D.L., Rosenheck, R.A., ... Heinssen, R.K. (2015). Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry (ahead of print). 

Mueser, K.T., Penn, D.L., Addington, J., Brunette, M.F., Gingerich, S., Glynn, S.M., ... Kane, J.M. (2015). The NAVIGATE program for first episode psychosis: Rationale, overview, and description of psychosocial components. Psychiatric Services, 66 (7), 680-690.

Funded by the New York State Office of Mental Health, the OnTrackNY Initiative has been providing Coordinated Specialty Care (CSC) treatment to young people experiencing First Episode Psychosis (FEP) in New York State since 2013. The goal of OnTrackNY is to help young adults with newly emerged non-affective psychotic disorders achieve their goals for school, work, and social relationships. OnTrackNY treatment teams serve up to 35-50 individuals age 16-30, depending on staffing, and provide a range of treatment including: case management for social and community needs, supported employment and education, FEP-relevant psychotherapy, pharmacotherapy and primary care coordination, and family support and education. Principles of care include shared decision making, youth friendly and welcoming environments, and flexible and accessible recovery oriented services.

Ten OnTrackNY programs are currently operating in New York State, with plans to open an additional ten programs in 2016. The existing programs have demonstrated desired outcomes in terms of both symptoms and functioning in areas such as work and school. To date, the program has enrolled 284 individuals of whom virtually all have a schizophrenia spectrum disorder. Retention rates are high, with 83% of patients remaining in treatment after one year. Rates of school and work participation have almost doubled, with 46% enrolled in work or school at baseline and 80% after one year of treatment. Rates of hospitalization have declined substantially, with 71% of clients experiencing a recent hospitalization at baseline and just 13% after 1 year. As part of the OnTrackNY Initiative, clinical teams receive intensive training and technical assistance from the Center for Practice Innovations (CPI) at the New York State Psychiatric Institute led by Dr. Lisa Dixon who was a Principal Investigator for the Recovery after an Initial Schizophrenia Episode Implementation and Evaluation Study (RAISE IES). The training team at CPI also provides consultation and train ing in FEP services to state leaders and clinical teams around the country. Learn More »