Pathways to possibility: central virginia early psychosis prevention and recovery program - horizon behavioral health will implement a CHR-p program to identify, assess, and intervene with youth and…

The Department of Health and Human Services Substance Abuse and Mental Health Services Administration awarded Horizon Behavioral Health $428,000 on September 30, 2026, under the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (CFDA 93.104) program to implement Pathways to Possibility, a coordinated, evidence-based early psychosis prevention and recovery program in Central Virginia.

Horizon Behavioral Health will identify, assess, and intervene with adolescents and young adults ages 15–25 at clinical high risk for psychosis through a stepped-care model incorporating screening, cognitive behavioral therapy for psychosis, care coordination, peer support, family education, and psychiatric consultation. The program will serve 20 unduplicated individuals in year one, 25 in year two, 30 in year three, and 35 in year four, totaling 110 youth and young adults over the four-year performance period. Services are family-driven, youth-guided, trauma-informed, culturally responsive, and recovery-oriented; participants may present with co-occurring anxiety, depression, trauma-related symptoms, suicidality, and substance use disorders. The project will use evidence-based screening and assessment tools including the Prodromal Questionnaire-Brief, Structured Interview for Prodromal Syndromes, Positive and Negative Syndrome Scale, and WHO Disability Assessment Schedule.

Performance occurs in Lynchburg, Virginia and the surrounding counties of Amherst, Appomattox, Bedford, and Campbell, serving a service area of approximately 269,000 residents. The period of performance runs through September 29, 2030.

Pathways to possibility: central virginia early psychosis prevention and recovery program - horizon behavioral health will implement a CHR-p program to identify, assess, and intervene with youth and young adults at risk for developing psychotic disorders. The project will establish a coordinated, evidence-based stepped-care model that promotes early identification, reduces psychiatric crises and hospitalization, improves functioning, and strengthens family engagement. Through screening, assessment, cognitive behavioral therapy for psychosis (CBT-p), care coordination, peer support, family education, and psychiatric consultation, the project will address critical gaps in specialty behavioral health services across central virginia. The project will serve the city of lynchburg and the counties of amherst, appomattox, bedford, and campbell in central virginia. The service area includes approximately 269,000 residents. The project will serve 20 unduplicated individuals in year 1, 25 in year 2, 30 in year 3, and 35 in year 4, for a total of 110 youth and young adults over the four-year project period. The target population includes adolescents and young adults ages 15-25 who are experiencing attenuated psychotic symptoms, brief or intermittent psychotic-like symptoms, functional decline, or other indicators associated with clinical high risk for psychosis. Participants may also present with CO-occurring behavioral health conditions, including anxiety, depression, trauma-related symptoms, suicidality, and substance use disorders. Services will be family-driven, youth-guided, trauma-informed, culturally responsive, and recovery-oriented. The project will implement evidence-based screening and assessment tools, including the prodromal questionnaire-brief (PQ-b), structured interview for prodromal syndromes (sips/mini-sips), positive and negative syndrome scale (panss), world health organization disability assessment schedule (whodas 2.0), and american society of addiction medicine (asam) criteria. Clinical interventions will include cognitive behavioral therapy for psychosis (CBT-p), psychoeducation, family engagement, peer support, academic and vocational support, psychiatric consultation, individualized crisis planning, and coordinated service navigation through a stepped-care framework. Project goals are to: (1) implement CHR-p screening and assessment practices; (2) establish regional referral pathways through outreach and cross-system collaboration; (3) increase access to evidence-based early intervention; (4) improve clinical, functional, educational, vocational, and behavioral health outcomes; and (5) promote family-driven and youth-guided care. Key objectives include: training 100% of CHR-p staff and designated referral personnel in approved screening and assessment tools; serving 110 unduplicated youth and young adults during the project period; linking at least 75% of enrolled participants to care coordination services; achieving measurable improvements in psychosis-risk symptoms and functioning among at least 60% of participants; reducing psychiatric crisis events among enrolled participants by 20%; improving school attendance, engagement, or functioning for at least 65% of participants; and ensuring that at least 75% of youth and families report satisfaction with services and involvement in treatment planning.