Project Grant H79SM089796

COMMUNITY PROGRAMS FOR OUTREACH AND INTERVENTION WITH YOUTH AND YOUNG ADULTS AT CLINICAL HIGH RISK FOR PSYCHOSIS - THE LOUISIANA DEPARTMENT OF HEALTH, OFFICE OF BEHAVIORAL HEALTH PROPOSES TO EXPAND THE EXISTING PARTNERSHIP WITH TULANE UNIVERSITY'S EARLY PSYCHOSIS INTERVENTION CLINIC IN NEW ORLEANS (EPIC NOLA) TO SERVE YOUTH AND YOUNG ADULTS WHO ARE AT CLINICAL HIGH RISK FOR PSYCHOSIS (CHR). THIS INCLUDES ESTABLISHING A CHR TREATMENT TRACK FOCUSED ON YOUNG PEOPLE WHO EXHIBIT CHANGES IN PERCEPTION, THINKING, AND FUNCTIONING TYPICALLY PRECEDING THE FIRST EPISODE OF PSYCHOSIS (FEP). THIS GRANT PROJECT WOULD SUPPORT THE EXPANSION OF THE EPIC NOLA COORDINATED SPECIALTY CARE SERVICES (CSC) TO TARGET THOSE AT CLINICAL HIGH-RISK (CHR) FOR PSYCHOSIS. THIS WILL BE APPROACHED THROUGH THE IMPLEMENTATION OF A CHR TREATMENT TEAM, CLINICAL HIGH-RISK PROGRAM (EPIC-CHRP) AND A CHR COMMUNITY EARLY DETECTION CAMPAIGN IN NEW ORLEANS. THE CHR POPULATION OF FOCUS INCLUDES YOUNG PEOPLE, UP TO 25 YEARS OF AGE. THE TARGET AREA FOR THIS PROJECT IS THE NEW ORLEANS AREA, WHICH IS THE AREA CURRENTLY SERVED BY THE TULANE EPIC-NOLA CLINIC. NEW ORLEANS IS A VIBRANT AND DIVERSE COMMUNITY WITH A TOTAL POPULATION OF 389,6171 MADE UP OF 60% AFRICAN AMERICAN, 31% WHITE, AND ABOUT 6% HISPANIC RESIDENTS. NEW ORLEANS, IN ORLEANS PARISH, IS DESIGNATED A LOW-INCOME POPULATION OF A HEALTH PROFESSIONAL SHORTAGE AREA.2 THE MEDIAN HOUSEHOLD INCOME IS $36,792 (U.S. MEDIAN, $56,516). NEARLY 27% LIVE IN POVERTY,3 WITH HIGH PREVALENCE OF SEVERAL MEASURES OF SOCIAL STRESS THAT INCREASE RISK FOR PSYCHOSIS ONSET (EXPOSURE TO VIOLENCE, CHILD ABUSE AND DISCRIMINATION, AND HISTORY OF MIGRATION).4 THESE OVERLAP WITH PROGNOSTIC FACTORS SUCH AS POVERTY, LOW EDUCATIONAL AND OCCUPATIONAL ACHIEVEMENT, AND POOR ACCESS TO HEALTH SERVICES. LOUISIANA RANKS 50TH FOR PER-CAPITA FUNDING FOR COMMUNITY MENTAL HEALTH SERVICES AND 46TH IN ACCESS TO GENERAL MEDICAL SERVICES. STRATEGIES & INTERVENTION: PRIMARY, SECONDARY, AND TERTIARY PREVENTION STRATEGIES ARE BEING UTILIZED TO ADDRESS THE PURPOSES OF THIS GRANT WHICH ARE TO PROVIDE TREATMENT AND IMPROVE FUNCTIONING OF THE CHR POPULATION, TO REDUCE DURATION OF UNTREATED PSYCHOSIS AND/OR TO DELAY OR PREVENT PSYCHOSIS. EPIC NOLA CSC SERVICES WILL BE OFFERED FOR THE CHR POPULATION AND ADAPTED BASED ON EVIDENCE-INFORMED PRACTICES. WORKFORCE DEVELOPMENT STRATEGIES WILL BUILD CAPACITY FOR CHR ASSESSMENT. CURRENT COMMUNITY WIDE FEP EARLY DETECTION STRATEGIES WILL BE ADAPTED TO CHR EARLY DETECTION. GOALS AND OBJECTIVES: A GOAL OF THIS PROJECT IS TO INCREASE THE CAPACITY OF THE CURRENT EARLY PSYCHOSIS PROGRAM TO PROVIDE EVIDENCE-BASED CARE FOR THOSE AT CLINICAL HIGH-RISK FOR PSYCHOSIS THROUGH ESTABLISHING A DEDICATED CHR TEAM. 290 INDIVIDUALS WILL BE DIRECTLY SERVED IN THE 4-YEAR GRANT PERIOD (YEAR 1-20, YEAR 2-90, YEAR 3-90, AND YEAR 4-90). ANOTHER GOAL IS TO ENHANCE THE CAPACITY OF WORKFORCE DEVELOPMENT IN CHR ASSESSMENT AND TREATMENT, ACHIEVED THROUGH TRAININGS IN STANDARDIZED ASSESSMENTS AND INTERVENTIONS. THE 3RD GOAL IS TO INCREASE CAPACITY OF KEY COMMUNITY STAKEHOLDERS INTERFACING WITH THE AT-RISK POPULATION TO IDENTIFY THOSE EXPERIENCING CLINICAL HIGH-RISK PSYCHOSIS SYMPTOMS, ACHIEVED BY COMMUNITY CHR EDUCATION SESSIONS. THE 4TH GOAL IS STREAMLINING LOCAL PATHWAYS TO CARE TO EARLY PSYCHOSIS TREATMENT TO DELAY OR PREVENT PSYCHOSIS AND REDUCE DURATION OF UNTREATED PSYCHOSIS THROUGH PSYCHOSIS EARLY DETECTION STRATEGIES.