NYC START: A New Model for Securing Community Services for Individuals Hospitalized for First-Episode Psychosis

Abstract

and Mental Hygiene when individuals ages 18-30 are hospitalized for first-episode psychosis (FEP). This study examined the implementation of NYC START, a program that meets patients hospitalized with FEP to offer a voluntary, 3-month critical time intervention provided by social workers and peer specialists to connect individuals to appropriate community mental health services after discharge.Methods: Service logs completed by program staff were summarized to determine the mean number of contacts received per client per week, types of services provided by social workers and peer specialists, survival analyses of time to discharge from NYC START, and connection rates with community mental health services.• This study examined the implementation of NYC START, a program that meets patients hospitalized with FEP to offer them a voluntary, 3-month critical time intervention.• Of the 285 clients who accepted NYC START services in 2016, 87% attended an initial mental health appointment after hospital discharge and 78% completed at least 3 months of the program.• The program has been well received by clients, as evidenced by high enrollment rates, with the vast majority of enrollees continuing mental health services before discharge from NYC START.

“Real‐world” first‐episode psychosis care in Massachusetts: Lessons learned from a pilot implementation of harmonized data collection

“…In MA, the majority of clinics serve individuals aged 15–30, and include a range of psychosis diagnoses with an onset within 3 years. This is similar to reports from clinics in California and New York, though global differences exist in program eligibility criteria (Anderson et al, 2019; Niendam et al, 2019). With the expansion of early psychosis services and standardization of assessments to evaluate their impact, it is important to be aware of these inconsistencies; for example, the inclusion of affective or at‐risk patients, differing age ranges and varying insurance statuses of patients and healthcare contexts across countries.…”

Specialized inpatient treatment for young people with early psychosis: acute-treatment and 12-month results

“…Nevertheless, comprehensive EIS and outpatient treatments seem essential to improve patient´s engagement throughout long-term treatment [27]. However, since many young people with EP are hospitalized during their first psychotic episodes [22][23][24], specialized inpatient treatment for this population may represent the first step of specialized targeted interventions, and widen the scope of current well-evaluated and effective EIS. Thus, combining specialized inpatient treatment with outpatient EIS in young people with EP may help reduce and alleviate potential devastating consequences of EP for individuals, families, and societies.…”

“…Although many individuals with EP are hospitalized during the first psychotic episode [ 22 – 24 ] and often experience their first hospitalization as traumatic [ 25 ], all EIS evaluated in recent RCTs commenced after hospitalization as outpatient and/or assertive outreach treatments, and do not include specialized inpatient treatment [ 3 ]. To our knowledge, only two studies of specialized inpatients treatments for EP exist.…”