Aim Pennsylvania (PA) first‐episode psychosis (FEP) program evaluation is a statewide initiative, supported by the PA Office of Mental Health and Substance Abuse Services (PA‐OMHSAS) and administered by PA Early Intervention Center/Heads Up, which evaluates fidelity and outcomes of PA Coordinated Specialty Care (CSC) programs. Programs participate in standard computerized measures of CSC outcomes using centralized informatics. The aims of the current report are to describe implementation of this core battery for program evaluation in PA and to present 6‐ and 12‐month outcomes. Methods Participants (n = 697) from nine PA CSC programs completed the core battery at admission. The battery was re‐administered at 6‐ and 12‐month follow‐up, and data were analysed for individuals (n = 230) who had completed 12‐months of treatment. Domains assessed via clinician report and/or self‐report included symptoms, role and social functioning, self‐perceived recovery and service utilization. Results PA FEP CSC participants showed improvement over time in several domains, including decreased symptoms, higher role and social functioning, decreased hospitalizations, and improved self‐perception of recovery, quality of life, and services satisfaction. Trends towards improvements were observed for participant happiness, hopelessness, and school‐enrolment. Nearly all improvements were observed at 6‐month follow‐up, with earlier gains maintained at 12‐months. Conclusions PA FEP CSC programs demonstrate the ability to assess and improve critical outcomes of coordinated specialty care in PA. Improved outcomes by 12 months in treatment provides evidence of an effective treatment model and supports the continuation of these programs in pursuit of our goal of reducing schizophrenia disease burden on individuals and society.

Background Digital technology, the internet, and social media are increasingly investigated as promising means for monitoring symptoms and delivering mental health treatment. These apps and interventions have demonstrated preliminary acceptability and feasibility, but previous reports suggest that access to technology may still be limited among individuals with psychotic disorders relative to the general population. Objective We evaluated and compared access to and use of technology and social media in young adults with psychotic disorders (PD), young adults with clinical risk for psychosis (CR), and psychosis-free youths (PF). Methods Participants were recruited through a coordinated specialty care clinic dedicated toward early psychosis as well as ongoing studies. We surveyed 21 PD, 23 CR, and 15 PF participants regarding access to technology and use of social media, specifically Facebook and Twitter. Statistical analyses were conducted in R. Categorical variables were compared among groups using Fisher exact test, continuous variables were compared using 1-way ANOVA, and multiple linear regressions were used to evaluate for covariates. Results Access to technology and social media were similar among PD, CR, and PF participants. Individuals with PD, but not CR, were less likely to post at a weekly or higher frequency compared to PF individuals. We found that decreased active social media posting was unique to psychotic disorders and did not occur with other psychiatric diagnoses or demographic variables. Additionally, variation in age, sex, and White versus non-White race did not affect posting frequency. Conclusions For young people with psychosis spectrum disorders, there appears to be no “technology gap” limiting the implementation of digital and mobile health interventions. Active posting to social media was reduced for individuals with psychosis, which may be related to negative symptoms or impairment in social functioning.

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Background The early years following a first episode of psychosis (FEP) present unique opportunities to prevent declines in clinical and social function. Early intervention programs target factors known to be associated with poor long-term outcomes, including longer duration of untreated psychosis, treatment non-adherence, affective symptoms, and cognitive dysfunction. The RAISE trial and other work in the U.S. and internationally spurred congress to fund comprehensive specialty care (CSC) programming across the US through a SAMHSA block-grant set-aside that began in 2015 and was doubled in 2016. As a Pennsylvania recipient of these funds since 2015, the Penn Psychosis Evaluation and Recovery Center (PERC) enrolls individuals age 15–34 who have experienced psychosis onset within two years prior to enrollment. We received complementary funding in 2018 to provide step-down care to FEP participants, and to expand PERC services to individuals at clinical high risk for psychosis. Methods PERC services, offered for a minimum of two years, include pharmacotherapy, recovery oriented cognitive therapy and case management, supported employment and education, multi-family group cognitive therapy and psycho-education, peer support, and cognitive remediation. SAMHSA funds are used to provide CSC elements that cannot be supported through available insurance coverage. A comprehensive computerized assessment, conducted at admission and at 6-, 12-, 18- and 24- month follow-up intervals, includes measures from the Pennsylvania FEP Program Evaluation core battery assessing participant-level outcomes (employment and education, hospitalization, criminal justice involvement and risk behaviors, and overall functioning and clinical symptoms), complemented by standardized measures of cognitive insight, sleep quality, and other relevant domains. Systems-level data on outreach efforts, incoming and outgoing referrals, admissions and discharges are also collected. Data collection is integrated into clinical care. Results To date, PERC has enrolled 202 individuals (mean age=22.2, SD=4.4; 78% male; 56% European-American, 31% African-American, 13% other), of whom 106 consented to use of clinical data for research purposes. Admission and 6- month follow-up data reflect improved psychosis and mood symptoms, increased engagement in employment or school, and low re-hospitalization rates. Clinician rated global role and social function significantly increased by 6-month follow-up. Participants self-reported significantly increased satisfaction with mental health services and improved perception of their recovery process at 6-month follow-up. Duration of untreated psychosis prior to PERC admission (mean=7.4 months, SD=7.4) was not correlated with improvements in global role or social function at 6-months. Clinical and functional changes beyond 6 months remain to be analyzed. Discussion Our results add to growing evidence that individuals who have experienced a first episode of psychosis benefit from participating in comprehensive interventions that can improve clinical symptoms, function and quality of life. They also provide further evidence of the feasibility and clinical utility of FEP CSC programs supported by federally mandated funds, which can reduce the personal and societal burdens associated with psychotic disorders. As our program continues to expand, ongoing comprehensive assessment across the early psychosis spectrum will afford evaluation of longer-term therapeutic benefits and analyses of predictors of varying outcomes.

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