Community prevention and intervention of individuals at clinical risk for psychosis - through the early detection screening and stepped care intervention for clinical high risk for psychosis…

The Department of Health and Human Services Substance Abuse and Mental Health Services Administration awarded Austin-Travis County Mental Health And Mental Retardation Center, operating as Integral Care, $650,000 on September 30, 2026, under the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED) program (CFDA 93.104).

Integral Care will implement a tiered early detection screening and stepped-care intervention model for youth and young adults ages 15–25 in Travis County, Texas to identify individuals at clinical risk for psychosis and connect them to evidence-based services that prevent or lessen psychotic disorder severity and reduce the duration of untreated psychosis. The project prioritizes young people transitioning from child to adult mental health services, individuals referred from secondary and post-secondary educational institutions, and those serviced by local youth-serving organizations. The intervention comprises two components: tiered early detection screening and assessment (including universal screening via the Prodromal Questionnaire) and stepped-care intervention matched to each individual's risk level.

The award period runs from September 30, 2026, through September 29, 2030, with performance in Austin, Texas. Work is delivered collaboratively with UT Dell Medical School and the Meadows Mental Health Policy Institute, which expand outreach, screening, and develop evidence-informed educational and training materials. The target population includes approximately 165,902 individuals in the 15–24 age range residing in Travis County, with an estimated 1,600 expected to experience a psychotic episode during their lifetime based on approximately 3 percent psychosis prevalence.

Community prevention and intervention of individuals at clinical risk for psychosis - through the early detection screening and stepped care intervention for clinical high risk for psychosis project, integral care, austin and travis county's local mental health authority, will implement a tiered early detection screening and stepped care intervention model for youth and young adults ages 15-25 in travis county, texas to identify those at risk for psychosis and connect them to evidence-based services to prevent or lessen the severity of psychotic disorder and to reduce the duration of untreated psychosis. This grant will support a collaborative effort among integral care, UT dell medical school, and the meadows mental health policy institute to expand outreach, screening and develop evidence-informed educational and training materials. The target population includes youth and young adults ages 15-25 residing in travis county, texas. Travis county had a population of 1,290,188 in the 2020 census, with approximately 165,902 individuals in the 15-24 age range (16.2% of total population). Given a lifetime psychosis prevalence of approximately 3%, an estimated 1,600 individuals in the 15-25 age cohort can be expected to experience a psychotic episode. The project will prioritize young people transitioning from child to adult mental health services, individuals referred from secondary and post-secondary educational institutions as well as local organizations servicing youth and young adults. This project includes two components: (1)tiered early detection screening and assessment, and (2)stepped-care intervention. These two components work together to ensure all young people are screened to detect risk for psychosis as early as possible, and that they are connected with the most appropriate level of care given their risk. In step 1 of the model, individuals are administered a brief, universal screening (prodromal questionnaire) and receive outreach and education around psychosis risk. From there, steps 2-4 implement gradually more thorough and symptom-specific screenings and assessments paired with higher levels of intervention, including peer support, supported employment and education, psychotherapy, and case management. Step 4, the highest level of the model, is coordinated specialty care for first episode psychosis (CSC FEP) those who meet the criteria. Goals include: (1)provide mental health providers with comprehensive training in the early identification of psychosis risk symptoms and the utilization of evidence-based screening tools. (2)develop training and educational materials tailored to both mental health providers and youth-serving organizations.; (3)broaden the implementation of the PQ-B screening tool, develop structured referral pathways, and administer the sips assessment as clinically appropriate.; (4)develop formalized referral pathways to first episode psychosis coordinated specialty care teams and supportive community-based resources. (5)implement a stepped care model that integrates symptom identification and comprehensive education for participants, families, and natural support systems to enhance overall care, (6)foster meaningful youth engagement and sustain participant retention in services, and (7)promote the development, implementation, and utilization of individualized evidence-based crisis planning tools, including the stanley-brown safety planning intervention. The project will screen a minimum of 600 individuals annually (500 new adult clients ages 18-25 and 100 clients ages 15-17), enroll 20 individuals the first year and 25 each year following into CHR-P monitoring, and serve up to 95 unduplicated individuals in CHR-P monitoring over four years. The project will train a minimum of 60 providers per year in tiered screening tools and CHR-P best practices and will conduct outreach to at least one secondary or post-secondary institution per quarter. Total unduplicated individuals screened across four years: 95.