SA130. Comparison of 2 First-Episode Psychosis Programs in Philadelphia

Abstract

Background: Research across the globe has demonstrated better outcomes for young people experiencing their frst episode of psychosis when treated using integrated treatment (IT) for FEP. In the United States, as federally mandated funding has become available to states, research is moving swiftly into implementation both at the community and at the academic medical center level. Two University of Pennsylvania FEP programs were implemented in West Philadelphia serving the same geographic area but with varying program designs and serving populations with different socioeco-nomic backgrounds. Methods: Both programs launched in the frst quarter of 2015. The Psychosis Evaluation and Recovery Center (PERC) serves Pennsylvania residents with private insurance who have experienced psychosis onset within the past 3 years. The Psychosis Education, Assessment, Care, and Empowerment (PEACE) program serves individuals in Philadelphia county receiving Medicaid within the frst year of psychosis onset. Both programs provide psychopharmacology, cognitive-behavior therapy, and case management. Additional PERC services include a cognitive remediation group, vocational services evaluation and referral as appropriate, and family group Psychoeducation. Additional PEACE services include community-based care, occupational therapy, supported employment and supported education, individual and group family therapy, and group therapy and activities. To evaluate program effectiveness, a comprehensive assessment battery was developed and implemented at intake and 6-month follow-up intervals. Results: To date, 159 participants have been enrolled across both programs. Both groups are young (mean age PEACE = 20, mean age PERC = 21). PERC participants are racially diverse (Caucasian = 52%, African American = 30%, Other = 18%), whereas PEACE participants are predominantly African American (80%; Caucasian = 10%, Other = 10%). The majority of PERC participants are privately insured, while 98% of PEACE participants receive Medicaid based on family income requirements. PERC participants tend to have at least 1 involved family member, while PEACE participants tend to have low family involvement and often have a family member with severe mental illness and/or active substance abuse. Nearly half of PEACE participants have had Department of Human Services involvement at some point in their lives, and over half were abusing drugs at baseline. We will present data on comparable clinical and functional improvements with IT care stratifed by programs and despite demographic and socioeconomic differences. Conclusion: Differences in private/public insurance reimbursement schedules and socioeconomic factors between the 2 clinical groups led to differences in service delivery and levels of service intensity. Nonetheless, early service utilization and clinical data support the value of state funded FEP programs.