SU130. Implementation of First-Episode Psychosis Programs in Philadelphia

Abstract

Background: Timely and comprehensive intervention at frst-episode psychosis (FEP) offers considerable promise for clinical and functional improvement. In the United States, the recently completed RAISE 2-year multisite frst-episode treatment trial has delineated the effcacy of this effort and spurred the allocation of federal funds through SAMSHA at the state-level to implement pilot treatment efforts. Beginning in 2015, the University of Pennsylvania (UPENN) has received support to implement efforts that encompass community education, recruitment, and integrated treatment (IT) services for young persons with FEP ages 14-35 years. Method(s): Two UPENN programs were established at separate locations in West Philadelphia with particular emphasis on providing individualized IT to FE persons. PEACE (PI: Hurford), which services the Medicaid population within Philadelphia County and PERC (PI: Kohler), which mainly services commercially insured patients from the Greater Philadelphia area. The 2 programs combined recruit a frst-episode patient group that refects the population diversity of the area. IT comprises comprehensive diagnostic and family assessments, resilience-based cognitive behavior therapy, medication management, case management and occupational support, family education/interventions and, for a subgroup, cognitive remediation. SAMSHA funds are used to provide elements of IT that presently cannot be supported through available insurance coverage to provide a comprehensive care model. Result(s): To date, the combined efforts have enrolled 157 persons (M:F PERC = 74:25; PEACE = 42:15) experiencing early psychosis (mean age PERC = 21, PEACE = 20). Preliminary 6-and 12-month data for both programs suggest considerable improvement in clinical symptoms and social/occupational functioning, and low rehospitalization rates. Utilization of IT services, rates of substance use, and legal problems were also evaluated. Conclusion(s): Preliminary results from the UPENN FEP programs illustrate the feasibility to provide community education about early psychosis, recruit and retain FE persons, and effectively implement IT with favorable outcome. Given the high rate of treatment nonadherence and relapse in this population, our pilot data offer support for creating effective IT programs in FEP patients with partial support of federally mandated funding.