CHR-P STRONG (Supporting Treatment, Resiliency, Outreach, Networking, and Growth) - Project Abstract: CHR-P STRONG Kentucky's Clinical High Risk for Psychosis (CHR-P) Supporting Treatment, Resiliency, Outreach, Networking, and Growth (STRONG) initiative will establish a developmentally responsive and person-centered CHR-P model for youth and young adults ages 12-25 in the Seven Counties Services region. Led by DBHDID in partnership with Seven Counties Services, STRONG will build on Kentucky's Coordinated Specialty Care/iHOPE infrastructure to identify and support youth and young adults before first episode psychosis. The project will implement screening, assessment, stepped-care intervention, shared decision-making, family engagement, crisis planning, and statewide capacity-building activities to strengthen Kentucky's early psychosis continuum. STRONG will serve Jefferson, Bullitt, Henry, Oldham, Shelby, Spencer, and Trimble counties, a geographically diverse region that includes urban, suburban, and rural communities and a total population of 1,045,944. The region includes 232,123 youth under age 18 and is home to multiple colleges, universities, and post-secondary training programs serving transition-age youth and young adults. STRONG will directly serve 92 youth and young adults over the project period. Thousands more will be served indirectly through outreach, awareness and education initiatives. The population of focus includes youth and young adults ages 12-25 who are at clinical high risk for psychosis or who present with attenuated psychotic symptoms, functional decline, or related behavioral health concerns warranting CHR-P screening, assessment, referral, and stepped-care intervention. Participants are expected to include male and female youth and young adults from diverse socioeconomic backgrounds, including individuals experiencing poverty, housing instability, transportation barriers, limited access to specialty behavioral health care, juvenile justice or child welfare involvement, trauma exposure, and co-occurring anxiety, depression, trauma-related symptoms, or substance use concerns. STRONG will implement evidence-based and evidence-informed strategies including PRIME Screen/PQ-B psychosis-risk screening; SIPS/Mini-SIPS and SCID-5 assessment and diagnostic procedures; a developmentally responsive stepped-care model; CBT-informed early intervention supports; structured cognitive-behavioral interventions, including CBT-P, CBT-R, and TF-CBT when clinically indicated; psychoeducation; family engagement; youth and family peer support; integrated intervention for co-occurring conditions; educational and vocational supports informed by IPS principles; psychiatric consultation when clinically indicated; individualized crisis planning; referral pathway development; outreach and education; workforce development; fidelity monitoring; and continuous quality improvement. Project goals are to: 1) increase SCS capacity to identify, screen, assess, and determine service eligibility for youth and young adults at CHR-P; 2) strengthen outreach, awareness, and referral pathways to improve early identification and timely access to CHR-P services; 3) implement and sustain a person-centered stepped-care model that provides evidence-based assessment, intervention, care coordination, family support, crisis planning, and continuity of care; and 4) strengthen Kentucky's statewide capacity to identify, assess, refer, and respond to youth and young adults at CHR-P through workforce, referral, implementation, and system-support infrastructure. Measurable objectives include establishing STRONG staffing, leadership, and operational infrastructure within six months of award; developing a standardized CHR-P screening, assessment, and diagnostic pathway within six months; training STRONG workforce members in screening, assessment, stepped-care protocols, crisis planning, referral workflows, and evidence-based CHR-P interventions within six months; enrolling 92 unduplicated individuals over the project period.
