Does an integrated outreach intervention targeting multiple stages of early psychosis improve the identification of individuals at clinical high risk?

Abstract

Aims: To explore the impact of a targeted case identification intervention, with training and education regarding first-episode psychosis and clinical high-risk syndromes, on the referral and identification of those at high risk.Methods: Using a historical control design, referral information from pre-intervention and postintervention periods was collected via administrative data and clinician notes from a catchmentbased early psychosis service.Results: A significant increase in the number of referrals sent to the service's clinical high-risk unit was observed following the intervention (P = 0.01). The proportion of referrals eligible was significantly higher post-intervention (P = 0.03), with the majority (26/44, 59.1%) referred via the first-episode psychosis service unit.Conclusions: An integrated outreach intervention for both first-episode psychosis and the clinical high-risk state was effective in increasing referrals of eligible cases to the service's at-risk unit. Rather than being stage-specific, targeted case identification strategies and service integration should span across the early stages of psychosis. K E Y W O R D Sclinical high risk for psychosis, early case identification, first-episode psychosis, specialized early intervention services, targeted case identification

Changes in community providers' screening behaviours, referral practices, and clinical confidence following participation in an early psychosis educational campaign

“…To date, most studies evaluating the impact of EP outreach programmes have measured programme effects by determining changes in the number of referrals the specialty clinic(s) of interest have received (McIlwaine et al, 2019; Perez et al, 2015). By contrast, our study focused on intervention effects at the level of individual mental healthcare providers.…”

“…Despite the ubiquity of intensive outreach and education campaigns, relatively little empirical attention has been paid to the extent to which these interventions are effective in increasing providers' identification practices. Some studies evaluating the effectiveness of outreach campaigns have documented changes in the number of referrals received by the specific psychosis clinic(s) under study (Joa et al, 2008; McIlwaine et al, 2019; Perez et al, 2015), but the mechanisms by which outreach campaigns lead to increased referrals to specialty care remain unclear. It is possible that such changes may come about through enhancing providers' knowledge about psychosis and resources available for affected youth, decreasing their perceptions of stigma associated with specialty psychosis care, or increased motivation to regularly evaluate clients for psychosis (Golembo‐Smith et al, 2011).…”

Identification of Psychosis Risk and Diagnosis of First-Episode Psychosis: Advice for Clinicians

“…155 Although research on outreach campaigns for clinical high-risk programs is limited, available evidence suggests that a combined outreach program geared toward simultaneously increasing early access for individuals at CHR-P and individuals with FEP may increase eligible referrals to a CHR-P clinical service. 156 More research is needed on the design and delivery of effective community outreach campaigns to facilitate early identification and access to care for individuals at CHR-P. Lastly, expansion of early psychosis detection campaigns is particularly needed within underserved communities which often have limited access to mental health care, such as among individuals from underrepresented racial and ethnic groups and those within criminal justice settings. [157][158][159] Psychology Research and Behavior Management 2024:17…”

Examining the psychobiological response to acute social stress across clinical stages and symptom trajectories in the early psychosis continuum

“…The current study includes data collected on 134 subjects (45 healthy controls, 28 individuals at CHR, and 61 FEP), all aged 14-35 years, who participated in a project on the neurobiology of stress in early psychosis (M. Pruessner, Béchard-Evans, et al, 2013;Seitz et al, 2019). CHR and FEP subjects were all patients at the Prevention and Early Intervention Program for Psychosis (PEPP) in the Douglas Mental Health University Institute in Montreal, Canada, where they received phase-specific medical and psychosocial treatment and follow-up for up to two years (S. Iyer et al, 2015;McIlwaine et al, 2019;M. Pruessner, Faridi, et al, 2017).…”