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Symposia

Schizophrenia / Psychotic Disorders

Innovative Stepped-Care Implementation Models for Community-Based Identification and Treatment of Individuals at Clinical High Risk for Psychosis: Implementation Strategies, CBT, Common Challenges

4 - (SYM 67)Partnering with Community Stakeholders to Increase Pathways to Stepped Care for Youth at Clinical High Risk for Psychosis: Initial Findings from Supporting Wellness for Adolescents and Young Adults

Saturday, November 16, 2024

8:30 AM – 10:00 AM EST

Location: Regency Ballroom A, Second Floor Mezzanine, Loews Hotel

Speaker(s)

EM

Elaina Montague, Ph.D. (she/her/hers)

Northwell Health Zucker Hillside Hospital
Glen Oaks, New York, United States

Co-author(s)

TM

Timothy Michaels, Ph.D.

Postdoctoral Fellow
The Zucker Hillside Hospital
Glen Oaks, New York, United States
MB

Michael Birnbaum, MD

Co-Prinicipal Investigator
Northwell Health
Glen Oaks, New York, United States
DA

Doron Amsalem, MD

Co-Prinicipal Investigator
Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute
New York, New York, United States
IN

Ilana Nossel, M.D.

Assistant Professor of Clinical Psychiatry
Columbia University
New York, New York, United States
IB

Iruma Bello, Ph.D.

Assistant Professor of Clinical Psychology in Psychiatry
Columbia University
New York, New York, United States
RL

Rufina Lee, MSW, PhD

Associate Professor, Silberman School of Social Work
Hunter College
New York, New York, United States
SJ

Samantha Jankowski, MA

Doctoral Candidate
Department of Psychology, Hofstra University
Hempstead, New York, United States
MM

Mili Mehta, MPD

Co-founder
Strong365Lab
Orinda, California, United States
CG

Chantel Garrett, MPH

Co-founder
Strong365Lab
Orinda, California, United States

Abstract Body

Background: Pathways to care for clinical high risk for psychosis (CHRp) are complex often due to lack of specialty care and limited community awareness of psychosis risk across common help-seeking settings like primary care, emergency services, schools, community programs, and online platforms. Additionally, delays in seeking help arise from insufficient understanding of psychosis risk, difficulty recognizing warning signs of CHRp, and apprehensions regarding stigma or involuntary treatment. This presentation describes how a new SAMHSA-funded stepped care CHRp program called SWAY (Supporting Wellness for Adolescents & Young Adults) partnered with community stakeholders to increase supportive pathways to care for CHRp.

Methods: Three strategies aimed to improving pathways to SWAY including a) enhancing early identification and screening of CHRp through community education and workforce training in common help-seeking settings; b) collaborating with stakeholders, such as youth and family councils, early psychosis organizations (Strong 365, OnTrack Central), and researchers to tailor outreach initiatives and develop a modularized cognitive behavioral therapy (CBT) intervention; c) co-developing digital outreach strategies, such as web-based help-seeking platforms and first-person TikTok-style videos to encourage help-seeking among adolescents.

Results: To date, SWAY has conducted outreach and provided CHRp training to over 300 professionals and community members, screened and evaluated 100 young people for CHRp, and delivered modular CBT-based services (Thompson et al., 2015) to 24 participants (mean age=19, SD=4.14). SWAY participants exhibit diverse racial/ethnic identities (Asian: 20.8%, Black: 25%, Multiracial: 8.3%, White: 20.8%; Hispanic/Latinx: 16.7%) and genders (females: 33.3%, males: 50%, non-binary/gender non-conforming: 12.5%). Baseline levels of suicidal ideation (37.5%), lifetime trauma exposure (50%), and psychological co-morbidity (83.3%) were high. At 6-month follow-up, participants reported improvements in mental health, social connectedness, and daily functioning, with reduced emergency and crisis utilization.

Conclusions: Developing partnerships with community-based stakeholders may facilitate pathways to stepped care by reducing complexity and increasing awareness for CHRp. Early access to evidence-based stepped care and modularized CBT may also reduce psychological distress in CHRp.