Reorienting the focus from an individual to a community-level lens to improve the pathways through care for early psychosis in the United States

Oluwoye, Oladunni; Nagendra, Arundati; Kriegel, Liat; Anglin, Deidre M.; Santos, María M.; López, Steven R.

doi:10.1016/j.ssmmh.2023.100209

Cited by 2 publications

(1 citation statement)

References 65 publications

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“…Shelton et al defined reach as the one component in RE-AIM that considers whether services equitably reach populations or communities and how neighborhood determinants may or may not influence reach [ 7 ]. The overall reach of mental health services to individuals in the early stages of psychosis may vary based on the neighborhood characteristics where individuals reside by shaping where services are implemented and the type of mental health services that are offered [ 8 ]. Prior research has demonstrated that historically minoritized and/or underserved communities have less access to mental health and specialty care services, resulting in disparities [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis

Oluwoye,

Lissau,

Stokes

et al. 2023

Implement Sci Commun

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Background Approximately 115,000 young adults will experience their first episode of psychosis (FEP) each year in the USA. Coordinated specialty care (CSC) for early psychosis is an evidence-based early intervention model that has demonstrated effectiveness by improving quality of life and reducing psychiatric symptoms for many individuals. Over the last decade, there has significant increase in the implementation of CSC programs throughout the USA. However, prior research has revealed difficulties among individuals and their family members accessing CSC. Research has also shown that CSC programs often report the limited reach of their program to underserved populations and communities (e.g., ethnoracial minorities, rural and low socioeconomic neighborhoods). Dissemination and implementation research focused on the equitable reach and implementation of CSC is needed to address disparities at the individual level. Methods The proposed study will create a novel integrative multi-level geospatial database of CSC programs implemented throughout the USA that will include program-level data (e.g., geocoded location, capacity, setting, role availability), provider-level data (race, ethnicity, professional credentials), and neighborhood-level census data (e.g., residential segregation, ethnic density, area deprivation, rural-urban continua, public transit time). This database will be used to characterize variations in CSC programs by geographical location and examine the overall reach CSC programs to specific communities. The quantitative data will be combined with qualitative data from state administrators, providers, and service users that will inform the development of dissemination tools, such as an interactive dashboard, that can aid decision making. Discussion Findings from this study will highlight the impact of outer contextual determinants on implementation and reach of mental health services, and will serve to inform the future implementation of CSC programs with a primary focus on equity.

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Section: Introductionmentioning

confidence: 99%

Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis

Oluwoye,

Lissau,

Stokes

et al. 2023

Implement Sci Commun

Self Cite

View full text Add to dashboard Cite

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Over 30 years of STEP: The Pittsburgh experience with first‐episode psychosis

Wood,

Jones,

Eack

et al. 2024

Early Intervention Psych

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AimsFor over 30 years, combined research and treatment settings in the US have been critical to conceptualizing care for first‐episode psychosis (FEP). Here we describe an early example of such a context, the Services for the Treatment of Early Psychosis (STEP) clinic, which is affiliated with the University of Pittsburgh.MethodsWe describe STEP's historical roots and establishment in the early 1990s; STEP's research and treatment contributions, alongside its growth and ongoing leadership.ResultsResearch‐based clinics, like STEP, preceded and helped pave the way for the Recovery After an Initial Schizophrenia Episode project in the US and the ensuing Coordinated Specialty Care (CSC) approach, now widely adopted in the US. Early clinic‐based research at STEP helped establish protocols for psychopharmacology, the relevance of effective early treatment, including psychosocial approaches, and highlighted disparities in treatment outcomes across race/ethnicity. Multidisciplinary collaboration and dialogue with consumers contributed to early treatment, combining psychosocial and pharmacological approaches. STEP adopted CSC and is situated within a bi‐state Learning Health System. STEP has retained a relatively unique 5‐year treatment model and exists within continuum of care ideally suited to studying psychotic illness and treatment outcomes.ConclusionsSTEP remains the largest academic FEP clinic in Pennsylvania. Academic FEP clinics like STEP will have a critical role within Learning Health Systems nationally to model participatory approaches, sustain early intervention treatment quality and ongoing treatment developments.

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Reorienting the focus from an individual to a community-level lens to improve the pathways through care for early psychosis in the United States

Cited by 2 publications

References 65 publications

Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis

Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis

Over 30 years of STEP: The Pittsburgh experience with first‐episode psychosis

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