Impact of the COVID-19 Pandemic on the Employment and Educational Outcomes of Individuals in a First-Episode Psychosis Clinic

Szmulewicz, Alejandro G.; Öngür, Döst; Shinn, Ann K.; Carol, Emily E.; Dow, Jacqueline; Yılmaz, Nergiz; Durning, Peter; Sastry, Jayram M; Hsu, John

doi:10.1176/appi.ps.202100114

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…These authors also highlighted the importance of implementing procedures to provide care virtually, adapting appointments times and duration, and adapting materials for digital use. They describe specific challenges and mitigating strategies at the clinician-level per NAVIGATE role, such as challenges for SEE clinicians associated with the COVID-19 constricted labor market and unavailability of outreach visits (38,39). They described modifications similar to ours, such as shifting focus to practicing skills for remote learning and working and conducting job interviews remotely.…”

Section: Modificationsmentioning

confidence: 91%

The quick pivot: Capturing real world modifications for the re-implementation of an early psychosis program transitioning to virtual delivery

Tempelaar

Kozloff²,

Crawford³

et al. 2023

Front. Health Serv.

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BackgroundTeam-based Early Psychosis Intervention (EPI) services is standard of care for youth with psychosis. The COVID-19 pandemic required most EPI services to mount an unplanned, rapid pivot to virtual delivery, with limited guidance on how to deliver virtual clinical services or whether quality of re-implementation and treatment outcomes would be impacted. We used a structured approach to identify essential modifications for the delivery of core components and explored facilitators and barriers for re-implementation and fidelity of a virtually delivered EPI intervention.Materials and methodsNAVIGATE is a structured approach to team-based EPI. It provides detailed modules to guide delivery of core components including medication management, psychoeducation and psychotherapies, supported employment/education, and family education. Having initially implemented NAVIGATE at the Centre for Addiction and Mental Health (CAMH) in 2017, the EPI service transitioned to virtual delivery amid the COVID pandemic. Using a practice profile developed to support implementation, we detailed how core components of NAVIGATE were rapidly modified for virtual delivery as reported in structured group meetings with clinicians. The Framework for Reporting Adaptations and Modifications for Evidence-Based Interventions (FRAME) was used to describe modifications. Fidelity to the EPI standards of care was assessed by the First Episode Psychosis Fidelity Scale (FEPS-FS). Re-implementation barriers and facilitators and subsequent mitigation strategies were explored using structured clinician interviews guided by the Consolidated Framework for Implementation Research (CFIR).ResultsIdentified modifications related to the intervention process, context, and training. We identified contextual factors affecting the re-implementation of virtually delivered NAVIGATE and then documented mitigating strategies that addressed these barriers. Findings can inform the implementation of virtual EPI services elsewhere, including guidance on processes, training and technology, and approaches to providing care virtually.DiscussionThis study identified modifications, impacts and mitigations to barriers emerging from rapid, unplanned virtual delivery of EPI services. These findings can support delivery of high-quality virtual services to youth with psychosis when virtual care is indicated.

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Section: Modificationsmentioning

confidence: 91%

The quick pivot: Capturing real world modifications for the re-implementation of an early psychosis program transitioning to virtual delivery

Tempelaar

Kozloff²,

Crawford³

et al. 2023

Front. Health Serv.

View full text Add to dashboard Cite

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What impact did the COVID-19 pandemic have on psychosis and the delivery of early intervention psychosis services?

Cotter,

Smith,

Gao

et al. 2024

Schizophrenia Research

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Challenges and Opportunities in Mental Health Care for Transitional Age Youth (TAY): Lessons Learned from the COVID-19 Pandemic

Kim,

Wilson,

Van Deusen

et al. 2024

APS

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COVID-19, caused by the SARS-CoV-2 virus, began in late 2019. On March 11th, 2020, the World Health Organization (WHO) declared the virus a pandemic, and by March 13th, 2020, the United States (US) government declared the pandemic a national emergency and, subsequently, a global pandemic. Since then, the world has experienced an upheaval affecting every age group in almost every aspect of life. This was particularly true for young people. Globally, a number of studies indicated that the COVID-19 pandemic has had a significant impact on youth mental health measures. In the US, the Centers for Disease Control and Prevention (CDC) 2022 report showed that more than a third of high school students reported that they experienced poor mental health during the pandemic, and 44 percent reported feeling persistently sad or hopeless in the last 12 months. More than half (55 percent) reported experiencing emotional abuse by a parent or other adult at home, and 11 percent reported experiencing physical abuse. In addition, more than a quarter (29 percent) reported that a parent or other adult in the home lost their job. The pandemic upended not only daily life but also healthcare delivery throughout the world. Its vast impact on the healthcare system has disproportionately affected transitional age youth (TAY) between 15 to 25 years old. While the pandemic caused unprecedented changes and challenges, it was also a learning experience that deepened our understanding of our system of care, its strengths and vulnerabilities. This paper will discuss many challenges and opportunities associated with the delivery of psychiatric services for TAY in college mental health, emergency departments, and inpatient and outpatient settings, as well as in specialized programs, such as those for early psychotic disorders.

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Impact of the COVID-19 Pandemic on the Employment and Educational Outcomes of Individuals in a First-Episode Psychosis Clinic

Cited by 3 publications

References 24 publications

The quick pivot: Capturing real world modifications for the re-implementation of an early psychosis program transitioning to virtual delivery

The quick pivot: Capturing real world modifications for the re-implementation of an early psychosis program transitioning to virtual delivery

What impact did the COVID-19 pandemic have on psychosis and the delivery of early intervention psychosis services?

Challenges and Opportunities in Mental Health Care for Transitional Age Youth (TAY): Lessons Learned from the COVID-19 Pandemic

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