In 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) initiated a program to fund stepped-care intervention programs for youth and young adults at clinical high risk for psychosis (CHR-P).A study published today in Psychiatric Services reports that these SAMHSA grants have made a difference in young people’s lives: Individuals who participated in these comprehensive prevention and treatment programs experienced improvements across a range of behavioral, social, and medical outcomes.
How did it work?
John A. Cosgrove, Ph.D., of Westat, and colleagues analyzed outcomes for 1,071 young people (up to age 25) served at clinical sites that received a CHR-P grant. CHR-P grantees were required to implement a stepped-care intervention model, with the least intensive treatments (such as supported education and employment) delivered first, followed by higher-intensity treatments such as antipsychotic medication if needed.
The interventional goal was to improve the youths’ functioning, enable them to resume age-appropriate activities, and hopefully delay or prevent the onset of psychosis. Program participants completed comprehensive medical and psychosocial assessments at intake, every six months while receiving interventions, and at discharge.
What were the results?
As Cosgrove and colleagues noted: “Clients participating in these programs showed improved life functioning and social connectedness; decreased psychological distress; and low rates of hospitalization [and] emergency department visits.”
Early gains in social connectedness appeared to contribute to improved outcomes over the course of treatment. “This finding underscores the value of program components that build on social networks and relationships, such as involvement of family members in therapy, peer and family support specialists, and multifamily groups,” the researchers wrote.
Further, only 4% (N=39) of participants overall experienced first-episode psychosis while enrolled in the program. By comparison, population-level studies have found that about 15% of youth at high risk of psychosis will experience a first episode within one year.
For related information, see the Psychiatric News article “People at Risk of Psychosis Receiving Antipsychotics Tend to be Older, Have More Severe Profile
(Image: Getty Images/iStock/bymuratdeniz)
