Utah CHR-PTo implement the Prevention and Recovery of Early Psychosis program to prevent the onset of psychosis or lessen the severity of psychotic disorder among young people at clinical high risk. - The Utah Division of Substance Abuse and Mental Health (DSAMH) proposes to implement the Prevention and Recovery of Early Psychosis (PREP) program to prevent the onset of psychosis or lessen the severity of psychotic disorder among young people, not more than 25 years old, at clinical high risk for psychosis. The catchment area is the counties of Wasatch, Utah, Davis, and Weber-Morgan. Services will be provided by Wasatch Behavioral Health (WBH), Davis Behavioral Health (DBH), and Weber Human Services (WHS). PREP will implement a coordinated service system that provides community education, outreach, screening, assessment, and clinical care that is based on a stepped-care model. Utah's stepped-care model has four (4) levels of care: 1) Outreach and Engagement; 2) Low to Moderate Intensity and Risk; 3) High Intensity/High Risk; and 4) Transitioning out of CHR-P. The movement between levels is determined by assessment results, treatment response, and a shared-decision making framework that focuses on client-identified needs and preferences. Psychological intervention and recovery support services include: individual/family psycho-education, substance use risk reduction, Cognitive Behavioral Therapy for Psychosis (CBTp), skills training, and recovery support. Pharmacotherapy will be considered only when psychological interventions are ineffective and there are escalating attenuated psychotic symptoms. Goal 1: Throughout the grant period, improve the symptoms and behavioral functioning of 144 individuals, not more than 25 years old, who experience CHR-P so they may resume age-appropriate functioning. By 9/30/2026, provide stepped-care intervention to 144 eligible individuals. By 9/30/2026, 80% of enrolled individuals will demonstrate improved functioning. All individuals experiencing first episode psychosis (FEP) will be referred to a FEP specialty program within one week. Goal 2: Improve community awareness, understanding, and collaboration on CHR-P. For each year of the grant, a minimum of 150 community members will receive information on CHR-P. For each year of the grant, a minimum of 5 youth and 5 family members/natural supports will be engaged in leadership/advocacy activities. By 9/30/2023, develop a referral network of a minimum of 30 agencies/organizations. Goal 3: Enhance organizational infrastructure and community readiness to support individuals experiencing CHR-P By 3/1/2023, develop an interagency networking process to ensure the three Centers (DBH, WBH, and WHS) collaborate in implementing CHR-P services. By 3/1/2023, develop a standardized CHR-P workflow that outlines program components, critical activities, and staff core competencies in the stepped-care model. For each year of the grant, a minimum of 100 cross system staff, including the medical community, will receive training to improve their knowledge and skills on supporting individuals experiencing CHR-P and making referrals. By 3/1/2023, develop a communication strategic plan to promote community awareness through community education and social marketing. The anticipated outcomes are: 1) preventing the onset of psychosis, lessening the severity of psychosis, and helping individuals resume age-appropriate functioning; 2) developing a standardized workflow guiding the service delivery among the three providers; 3) increasing community awareness on CHR-P; 4) ensuring fast entry into CHR-P services through expanded referral network and evidence-based assessment; and 5) seamless referral into FEP program for individuals transitioning from clinical high risk to full psychosis.
