New Network Aims to Transform Care of First-Episode Psychosis

The National Institute of Mental Health’s Early Psychosis Intervention Network (EPINET) aims to be a “learning health care network” continuously improving the care of patients with first episode psychosis (FEP).

EPINET consists of 101 community-based early psychosis programs and eight regional hubs that coordinate the programs across 17 states. The participating clinics use the EPINET Core Assessment Battery at baseline and follow-up for gathering a wide range of clinically relevant data on FEP. Those data are collected by the National Data Coordinating Center, operated by Westat.

EPINET is still young—the National Institute of Mental Health (NIMH) began funding the network in fall 2019—and its goal is to continuously generate new knowledge about FEP, the effectiveness of current interventions, and ways to improve care.

“Learning in real time is the goal,” said Robert Heinssen, Ph.D., director of the Division of Services and Intervention Research at NIMH, in an interview. “COVID slowed things down, but we now have the Core Assessment Battery that is used by all participating clinics. Now, the data coming in can be harmonized across settings and fed back to participating programs so that a program is able to see how its performance stacks up against national metrics in close to real time.”

The Core Assessment Battery collects information on symptoms, medication use, functioning, school participation, crisis service use, hospitalization, and other factors important to the treatment and outcome of patients with FEP. Susan Azrin, Ph.D., chief of the early psychosis prediction and prevention unit at NIMH, said the battery is posted on the EPINET website for clinicians who want to incorporate measurement-based care into their treatment of patients with FEP. Azrin also urged clinicians treating these patients to use the EPINET website to connect their patients to a participating FEP clinic.

EPINET is modeled on the Institute of Medicine’s vision for “learning health care” as a broad aspirational goal of the U.S. health care system. “That goal is to offer the best possible care, measure the impact of treatment at the point of delivery, and use data to continuously drive quality improvement,” Heinssen continued.

“This really has the potential to change the way we go about treating people with early serious mental illness and may be a harbinger for the way health care for larger populations can be organized,” he said.

For more information, see the Psychiatric News article, “New Network Collects Real-Time Data to Improve Treatment of Early Psychosis.”

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Members Invited to Apply for New Presidential Task Force on Social Determinants of MH

APA members are invited to apply for appointment to the new Task Force on the Social Determinants of Mental Health, which reflects the theme of incoming APA President Vivian Pender, M.D. There will also be eight work groups that will address major issues related to social determinants of mental health. The appointments begin on May 3 and end at the close of the 2022 Annual Meeting. Those interested should submit a CV, brief summary of expertise, and specific area of interest to TFSDOMH@psych.org by April 26.

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IPS Town Hall Focuses on NIMH Goals, Call for Ideas

The National Institute of Mental Health’s (NIMH) Division of Services and Intervention Research (DSIR) is “open for business,” said division director Robert Heinssen, Ph.D., at a special session yesterday at APA’s fall conference, IPS: The Mental Health Services Conference, in New Orleans.

Heinssen noted that a combination of Congressional funding and a drive by new NIMH Director Joshua Gordon, M.D., to accelerate the institute’s public health impact has led to the availability of resources for developing innovative interventions that can reach more people with mental illness. "We are looking for good ideas," he said.

One area of particular interest, Heinssen said, are clinical studies on interventions that factor in end-user deployment issues—that is, intervention designs that already take into account the characteristics or limitations of the target service area. For example, a study could include behavioral therapy in a bilingual format to make an intervention useful in a strongly Latino community or require limited resources so that even a small community clinic could afford the intervention. Once validated in research, these strategies could be rapidly disseminated where needed.

NIMH is also interested in harnessing the power of existing digital technology that incorporates principles from social psychology, such as affirmation and positive reinforcement, to provide “24/7” support to people with mental illness. Such tools include smartphone apps that allow continuous patient communication and technologies like “asynchronous telepsychiatry” in which interviews of patients by trained staff are videotaped for review by psychiatrists at a later time.

These comments were part of a townhall discussion by three leaders from the National Institutes of Health who described the current themes or strategies of their respective institutes. In addition to Heinsenn, the presenters were Wilson Compton, M.D., M.P.E., deputy director of the National Institute on Drug Abuse, and Aaron White, Ph.D., a senior scientific advisor to the director at the National Institute on Alcohol Abuse and Alcoholism.

(Image: Nick Zagorski)