The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) is committed to establishing and supporting evidence-based practices for youth and young adults (Y/YA) who are at clinical high risk for psychosis (CHR-P). TDMHSAS will serve as the locus of accountability for the Tennessee CHR-P and will be responsible for oversight of state and local grant related activities and outcomes. The CHR-P program will align with system of care guiding values and principles and will fall within an array of community-based services and supports focused on promotion, prevention, early identification, treatment, and recovery. The four CHR-P project goals are to 1) delay or prevent the onset of psychosis by increasing community awareness of the CHR-P program and early identification and screening procedures, 2) improve symptomatic and behavioral functioning in Y/YA at CHR-P, enabling them to resume age-appropriate social, academic, and/or vocational activities, 3) minimize the duration of untreated psychosis for Y/YA who develop psychotic symptoms, and 4) develop and implement capacity building strategies to provide sustained service delivery to Y/YA and their families. This will be accomplished through a partnership with a local service provider, Alliance Healthcare Services, who will implement targeted outreach and engagement strategies and co-locate an evidence-based stepped-care model for CHR-P with their existing coordinated specialty care program, OnTrackTN, in Shelby County, Tennessee. Due to the high prevalence of individuals who experience psychosis in this area as compared to other areas of the state, it is critical to provide early identification and intervention services to Y/YA ages 12 to 25 who are at CHR-P in order to have the greatest impact on prognosis and minimize the duration of untreated psychosis. By co-locating this CHR-P site with an existing OnTrackTN site, service provision for Y/YA on the psychosis spectrum in Shelby County will be enhanced, further minimizing and/or preventing the duration of untreated psychosis. Team-based services and supports will include access to individual and family psychoeducation, substance use risk reduction, Cognitive Behavioral Therapy for psychosis (CBT-p), supported employment and education, young adult and family peer support, evidence-based pharmacotherapy, as warranted, and case management. The stepped-care model will include evidence-based interventions of varying complexity, intensity, and duration that will be utilized to target symptoms, problems, and functional impairments characterizing different clinical high-risk states. It's anticipated that the CHR-P team will serve a total of 88 Y/YA by the end of the grant, including: 15 Y/Y in year 1, 25 Y/YA in year 2, 30 Y/YA in year 3, and 18 Y/YA in year 4. TDMHSAS will also utilize an existing staff within the Office of Research, Division of Administrative and Regulatory Services, who is the evaluator for our Healthy Transitions and First Episode Psychosis Initiatives to conduct evaluation, as well as develop and implement data protocols and procedures that will be used to inform changes in individual treatment and program implementation. This coordinated approach to care, in close collaboration with the OnTrackTN team within the same agency, will increase workforce capacity and create a more robust continuum of care for Y/YA in Shelby County at CHR-P experiencing a first episode of psychosis.