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Early-Phase Psychosis: Practice-Based Research to Improve Treatment Outcomes

Award Number: P01MH139136
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 06/02/2025
PERIOD OF PERFORMANCE END DATE: 05/31/2030

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Early-Phase Psychosis: Practice-Based Research to Improve Treatment Outcomes - Our group has a long-standing commitment to improving care for individuals with first episode psychosis (FEP), e.g. we developed the NAVIGATE coordinated specialty care (CSC) treatment model for the RAISE-ETP study. The current EPINET project allowed us to improve FEP care within a learning health system (LHS) framework. Our current ESPRITO EPINET has enrolled 963 participants. Our proposed ESPRITO EPINET will enroll an additional 625 participants from clinics in 5 states. All sites provide care with the NAVIGATE model, serve populations across varied geographic and community settings (including urban, suburban, and rural areas), and except for one are community facilities without any academic affiliations. Moving forward, the ESPRITO central team will continue to provide sites the successful supports developed in the current ESPRITO for LHS and research project recruitment, retention, obtaining core assessment battery (CAB) assessments, data management including provision of CAB data to the EPINET Data Coordinating Center. NAVIGATE treatment and the LHS model are based upon measurement-based care and we will continue on-going training to site personnel on assessment and the use of assessments to improve care. For the proposed work, we will expand the range of dashboards and means to convey information to sites. Our statistical analyses include innovations both in the methods that will be used and the incorporation of visualization tools to communicate the results to clinicians who may have limited statistical expertise. A novel measure will be used to evaluate social and environmental factors known to affect health outcomes—including social (e.g., percentage of veterans with disability), economic (e.g., median household income), education, built environment (e.g., households with internet connection), and health care access—to further characterize differences across clinical sites. Combining data from the current ESPRITO project and the proposed work will also permit adequately powered analyses of clinically meaningful subgroups, such as those defined by duration of untreated psychosis. To enhance sites’ ability to improve care the proposed work includes a learning collaborative about overall treatment issues and another about enhancing patient participation in the LHS and in NAVIGATE treatment. We will also mentor the next generation of LHS/CSC research and clinical leaders. We will also perform 2 research studies. 1) Determine clinical characteristics of individuals who disengage from the LHS or from NAVIGATE treatment. Using data that can be obtained during clinical care (e.g. the Core Assessment Battery) we will characterize patient participants who disengage at two levels: those who enroll in the LHS but do not participate in the data collection needed for measurement-based care and those who prematurely terminate all CSC treatment. 2) Determine the utility at real world clinics of automated speech and language analysis to identify participants at risk for treatment disengagement or for relapse and hospitalization. Automated speech and language analysis has the potential to provide sites important information about patient status beyond what is obtained by usual clinical measures. In addition to the 2 defined projects, we will also collaborate with other EPINET hubs via the EPINET research consortium and development of collaborative research projects. Beginning with the NIMH-funded Preventing Morbidity in First Episode Schizophrenia study [1] in 1998, our group has emphasized performing studies in community facilities where most individuals with FEP receive care. The RAISE-ETP study [2,3] expanded these efforts substantially. We developed an integrated coordinated specialty care (CSC) treatment program (named NAVIGATE) designed to be implemented in community settings and tested in 34 community facilities across the US. After RAISE-ETP, we have provided NAVIGATE training in 20 US states, Canada and China. The funding


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $1,503,322 )
2026	2026	THE FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	2	6/23/2026	NON-COMPETING CONTINUATION	$1,503,322
														Subtotal = $1,503,322

Issue Date FY: 2025 ( Subtotal = $1,659,568 )
2025	2025	THE FEINSTEIN INSTITUTES FOR MEDICAL RESEARCH	350 COMMUNITY DR	MANHASSET	NY	11030	NASSAU	USA	Mental Health Research Grants	000	1	6/2/2025	NEW	$1,659,568
														Subtotal = $1,659,568

Grand Total All Awards = $3,162,890

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Early-Phase Psychosis: Practice-Based Research to Improve Treatment Outcomes

Award Number: P01MH139136

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 06/02/2025

PERIOD OF PERFORMANCE END DATE: 05/31/2030

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