Early Psychosis: Creating an Intervention Network for Better Treatments

“Psychosis” refers to conditions that affect the mind so that there is some loss of contact with reality. According to the National Institute of Mental Health (NIMH), approximately 100,000 youth and young adults in the U.S. experience a first episode of psychosis every year. If untreated, psychotic symptoms can lead to significant challenges in life functioning. The longer symptoms go untreated, the greater the risk for more numerous and persistent problems.

Early intervention can improve symptoms and functioning, potentially making life disruptions more tolerable. To help develop models for effective treatment and service delivery for psychosis, the NIMH has established a broad research initiative called the Early Psychosis Intervention Network (EPINET).

National Platform of Study

For EPINET, Westat will create and coordinate a national platform—the EPINET National Data Coordinating Center (ENDCC)—to support the exchange of information regarding new and effective treatments. This involves facilitating and expediting practice-based research in clinics that offer evidence-based, coordinated care for persons in the early stages of psychosis.

“The research specifically aims to improve the identification, diagnosis, assessment, interventions, and outcomes for this condition,” says Abram Rosenblatt, Ph.D., Project Director and a Westat Vice President. “We expect the next 5 years to produce significant advances in measurement-based care for serious mental illness, as well as new scientific discoveries regarding the nature and treatment of first episode psychosis.”

Establishing Research Goals and a Collaboration Network

More than 5,000 early psychosis patients, ranging from teens to young adults, will participate over the 5-year period. The network will collaborate with up to 5 regional coordinated specialty care (CSC) networks, including 58 CSC programs in 9 states.

As the coordinating center for the regional scientific hubs, Westat will facilitate the sharing of

• Data collection strategies
• Early psychosis data
• Analytic methods
• Innovative clinical practices

In addition, we will

• Provide analytic support to researchers
• Disseminate findings to the broader medical and scientific community

“EPINET will fast become an exemplary early psychosis learning health system,” says Dr. Rosenblatt. “The recruitment of 5,000+ early psychosis patients will generate an unprecedented volume of data about early intervention in psychosis with unique opportunities for collaborative research across the regional networks.”

Westat Builds on Research

Westat has worked on first episode psychosis studies previously in which the community transitioned from child to adolescent to adult. These include 2 studies for the Substance Abuse and Mental Health Services Administration (SAMHSA).

Mental Health Block Grant 10% Set-Aside. For this study, co-funded by SAMHSA, NIMH, and the Assistant Secretary for Planning and Evaluation, we used a multisystem approach to assess 36 CSC programs to determine if they met the needs of young adults with first episode psychosis and to establish whether there was a relationship between CSC fidelity and outcomes. Preliminary results have already been presented at national conferences, and a public-use dataset will be created as part of the NIMH National Data Archive.

Child Mental Health Initiative National Evaluation program. For this program, we assessed the effectiveness and impact of 93 new system-of-care grants designed to expand, coordinate, and improve care for young people with serious emotional disturbances and their families. Our evaluation documented the results of a national framework for creating program policies and guiding future programs to best meet the needs of young people. The results are available in annual SAMHSA Reports to Congress.