PRIME Clinic: Community Program for Outreach and Intervention with Youth and Young Adults at Clinical High Risk for Psychosis - The PRIME Network, a partnership between the Connecticut Department of Mental Health and Addiction Services (DMHAS) and the Yale PRIME Clinic, will identify Connecticut youth aged 12-25 across at clinical high risk for psychosis (CHR-P) and deliver stepped care to prevent or delay serious mental illness. PRIME will screen over 5500 youth while building durable CHR-P detection and treatment capacity within Connecticut's public mental health system. Connecticut has approximately 692,636 youth ages 10 to 24, the majority of whom lack access to specialized CHR-P services. PRIME will serve 32 to 108 unduplicated individuals annually (more than 250 total over four years). The youth who qualify will be between the ages of 12 and 25 and will present with attenuated psychotic symptoms, functional decline across academic and social domains, and co-occurring mood, anxiety, trauma-related, and substance use conditions. Youth involved in juvenile justice, child welfare, and underserved communities will be prioritized through targeted outreach. PRIME will operate a statewide hub-and-spoke model: partner clinics will administer the PRIME Screen to all new intakes in the target age range; positive screens will be referred to the hub for comprehensive diagnostic evaluation; and CHR-P-eligible youth will receive individualized stepped care, including Brief Supportive Psychoeducation (BSP), Personalized CBT for Early Psychosis (P-CBTep), and psychiatric consultation. Statewide provider capacity will be built through a tiered training curriculum covering critical information about CHR-P and stepped care (CHR-P Trainings 101, 102, 103, and 202), monthly ECHO consultation, ad-hoc personalized consultation from PRIME, and dissemination of a co-branded CHR-P Provider Toolkit through DMHAS. PRIME aims to systematically identify CHR-P youth, deliver evidence-based stepped care, and build sustainable statewide capacity to prevent or delay psychosis onset. Over four years, PRIME will screen more than 5500 youth, complete more than 550 evaluations, enroll more than 250 in stepped-care services, and train more than 300 providers in CHR-P identification and stepped care. Enrolled youth are expected to show meaningful improvement in SIPS symptom severity and global functioning at 6- and 12-month reassessment, directly advancing SAMHSA's priority of improving access to evidence-based interventions to address serious mental illness.
