Thursday, November 21, 2024
11/21/2024
Young people at clinical high risk for psychosis (CHR-P) constitute a newly-recognized population in clinical need. New Haven County, Connecticut can be considered a demographic microcosm of the US and has only recently gained its first specialized treatment clinic for CHR-P. In this project, the PRIME Clinic (est. 1996) at Yale and the Connecticut Mental Health Center will continue to provide Stepped Care to clients ages 12-25 at CHR-P and their families while strengthening ties to its co-located sister First Episode Psychosis (FEP) STEP Clinic and other clinics within New Haven County to maximize its impact in the region. Through partnerships with three organizations providing mental health care to our target demographic, we will institute universal screening of all new mental health clients in participating clinics in New Haven County. Clients identified will be identified as being at CHR-P using the Structured Interview for Psychosis-risk Syndromes (SIPS). Those eligible and willing to participate will be provided with evidence-based Stepped Care. Stepped Care will consist of three evidence-based steps. In Step One, brief supportive psychoeducation will be offered to all clients. In Step Two, clients who have still not achieved remission will be considered for antipsychotic medication. Transition across steps will be guided by standardized clinical diagnostic assessments. Therapies will be flexibly administered in individual- and/or family-therapy format based on client preference. All clients will be offered evidence-based adjunctive care for co-occurring conditions as well as peer support from young peers with lived experience of CHR-P. The goals of the project are to: 1) improve symptomatic and behavioral functioning, 2) enable resumption of age-appropriate activities, 3) delay onset of psychosis, and 4) minimize duration of untreated psychosis (DUP) in youth and young adults with CHR-P within the catchment area. Care will be delivered with cultural and linguistic competence and awareness of issues of diversity and disparity and with consideration of family and youth input. Measurable objectives are: 1) by 8/30/23 and annually thereafter, PRIME will improve symptomatic and behavioral functioning at the 180-day and 360-day assessments compared to at enrollment; 2) by 8/30/23 and annually, PRIME will enable age-appropriate activities at 180-days compared to at enrollment; 3) by 8/30/24 and annually, PRIME will reduce the incidence of conversion to first episode psychosis at the 360-day assessment compared to average individual predicted risk at enrollment; 4) by 8/30/24 and annually, PRIME will reduce DUP among CHR-P clients who convert to psychosis as compared to first episode clinic enrollees. PRIME will conduct 100 outreach presentations a year to school, mental health, primary care, and social services. Through partnerships with three community organizations, we will conduct universal, self-report screenings of roughly 1000 new clients yearly, leading to in-person SIPS evaluation in those who are eligible. The cumulative number of individuals contacted through outreach efforts will be 200 by the end of year one and increase by 400 annually thereafter. The cumulative numbers of individuals referred to PRIME for screening will be 125 by the end of year one and increase by as many annually thereafter. A total of 120 new, unduplicated clients (30 per year) will be served across the 4-year award period.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
