University of Washington Department of Psychiatry And Behavioral Sciences

First Episode Psychosis (FEP)

Information on Implementation Model

Approximately 100,000 adolescents and young adults in the United States experience First Episode Psychosis (FEP) each year (calculated from McGrath, Saha, Chant, et al., 2008). With a peak onset occurring between 15-25 years of age, psychotic disorders such as schizophrenia can derail a young person’s social, academic, and vocational development and initiate a trajectory of accumulating disability.

Despite these complexities, early intervention with evidence-based therapies offers real hope for clinical and functional recovery. Both meta-analytic and narrative reviews of randomized and quasi-experimental treatment studies conclude that early intervention services for psychosis can improve symptoms and restore adaptive functioning in a manner superior to standard care (Bird et al., 2010; Penn et al., 2005).

Background of First Episode Psychosis (FEP) Program Development in Washington State

In its Federal Fiscal Year 2014 appropriation, Congress allocated additional funds to the Substance and Mental Health Services Administration (SAMHSA) to support evidence based practices for programs to address the needs of individuals experiencing early serious mental illness.  States were instructed by SAMHSA to utilize 5% of their Mental Health Block Grant (MHBG) allocation for services for individuals experiencing FEP.  Committed to serving state residents with psychosis with evidence-based best practices, in 2015, the Washington State Division of Behavioral Health and Recovery (DBHR) provided additional funding to compliment MHBG funding to initiate the First Episode Psychosis model for the state of Washington. These efforts have been spearheaded by Dr. Maria Monroe-DeVita from the University of Washington Department of Psychiatry and Behavioral Sciences. Evaluation efforts are being led by Dr. Mike McDonnell of Washington State University.

Washington State had 18,695 individuals diagnosed with psychosis disorders during the fiscal year of 2013. The goal is to provide intervention that maximizes speed and flexibility and minimizes barriers while utilizing a public health approach. An abundance of data accumulated over the past two decades supports the value of early intervention following the first episode of psychosis. Clinical research conducted world-wide supports a variety of interventions for ameliorating psychotic symptoms and promoting functional recovery in FEP, including low doses of atypical antipsychotic medications, cognitive and behavioral psychotherapy, family education and support and educational and vocational rehabilitation (Killackey et al., 2008; Nuechterlein et al., 2008; Nuechterlein et al., 2013). There is ample evidence that when people have access to early treatment and ongoing support, the likelihood of recovery increases significantly.

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