Learning to live independently for tomorrow (lift) - schizophrenia affects 1% of the population, causing enormous suffering, disability, and substantial societal costs

Timely engagement in CSC for youth with first episode psychosis (FEP) is critical to improve outcomes and support functional and symptomatic recovery. In new york state (NYS), otny has established a unified approach to delivering CSC to adolescents and young adults with FEP. Since inception, 27 otny programs have been developed across NYS, including 13 in our catchment area of manhattan, queens, brooklyn, and long island, providing CSC to over 3,000 youth statewide to date. Directed by DR. Birnbaum, the otny program at ZHH is the largest and most established and has provided care to over 300 youth. However, early intervention services are time limited. Otny programs are designed and resourced to provide CSC for approximately 2 years, after which, discharged patients (75% between the ages of 16-25 years) are usually referred to standard clinical care within the community. Critically, accumulating evidence demonstrates that the benefits of early intervention obtained during CSC do not persist post discharge after transitioning to standard care. Further, the risk of disengagement is heightened during the transition from CSC to standard care, increasing risk for medication non-adherence, symptomatic relapse, social isolation, unemployment, and substance use. Data also suggest that minority populations may be particularly susceptible to negative outcomes post-CSC discharge. Moreover, youth graduating otny have new clinical and developmental needs as they mature into young adults (and gain greater independence) that require dedicated supports yet receive insufficient attention in standard clinical care. Despite a clear need, effective care for youth graduating otny are lacking, resulting in repeated calls for innovative solutions designed to sustain gains and promote ongoing recovery. To address this critical service GAP, northwell health, in partnership with the NYS office of mental health (OMH), is proposing to develop a CSC step-down service at ZHH for youth ages 16-25 graduating from ZHH's otny site as well as those referred by other local otny sites. Leveraging our established expertise in recovery oriented care, the lift team will provide evidence-based and coordinated supports, using the critical time intervention (CTI) model designed to be integrated and delivered in conjunction with standard care, aiming to 1) extend and enhance the benefits of early intervention, 2) minimize disengagement during a critical time of transition (otny graduation), and 3) equip youth with the skills and resources they need to foster autonomy, independence, and to lead productive and fulfilling lives.