First-Episode Psychosis Clinic Lessens Suffering, Financial Burden

Offering early, clinical care to young people going through their first episode of psychosis would reduce the amount of suffering they experience, lower their financial burden and help them stay in work or school, according to a new study published in the journal Psychiatric Services.

The new clinical model, developed by researchers at Yale University and the Connecticut Department of Mental Health and Addiction Services (DMHAS), is a modified version of psychosis clinics from around the world. The final product is called the Specialized Treatment Early in Psychosis or (STEP) clinic, which would provide comprehensive care for early psychosis patients and the people who help take care of them.

Since the first episode of psychosis typically occurs in a person’s late teens or early 20s, it is important that clinicians adapt treatments to meet the needs of this population, the researchers say.

In the new program, the patient would be assigned to a team that coordinates medication, counseling and social skills training, as well as education of family members.

“Age-appropriate, client-centered care based on research that has proven to be effective is of the utmost importance,” said Pat Rehmer, DMHAS commissioner. “These types of intervention can be vital to recovery.”

If the new model becomes widely available, it would significantly reduce the suffering, disability, and financial costs of schizophrenia and related disorders, according to the authors of the study.

“The model is a pragmatic, effective, and economically feasible approach to early psychosis and one that is feasible to implement in real-world U.S. settings,” said Dr. Vinod Srihari, associate professor of psychiatry at Yale and lead author of the study.

The researchers recruited 120 individuals who met criteria for first-episode psychosis to either receive care at the STEP clinic or be given a referral to community providers based on their insurance coverage.

Three out of four in STEP care avoided hospitalization during the next year, compared to about half in the control group. Furthermore, patients in STEP were more likely to be in school, have jobs, or actively be seeking employment than those in usual systems of care.

The STEP clinic is based at the Connecticut Mental Health Center (CMHC), which is a public-academic partnership between Yale and DMHAS. The authors believe this is an optimal model for the delivery of care and innovative new services and can work in many areas of the country.

The clinic also launched a campaign called Mindmap designed to increase availability of services in towns surrounding New Haven.

“The message is simple: Treatment is available, effective, and the earlier, the better,” Srihari said.

Source: Yale University

 
Young man in a mental health clinic photo by shutterstock.