AUSTIN, Texas – Early or first-episode psychosis can be a first sign of serious mental illness such as schizophrenia. Acting quickly to connect a person with the right treatment at this early stage can be life changing and prevent many of the long-term impacts experienced by people with schizophrenia and related psychotic disorders.
A new, $5.6 million grant from the National Institute of Mental Health will address this need in Texas by creating EPINET-TX, a network of coordinated specialty care programs for early psychosis operating in public mental health centers across the state. The Steve Hicks School of Social Work’s Texas Institute for Excellence in Mental Health will serve as the network’s hub, in partnerships with researchers at Dell Medicine, Southern Methodist University, and Thresholds, Inc.
“Through EPINET-TX we will be able to create new knowledge to make a positive impact in the delivery of services and reduce the burden of psychosis on young Texans and their families,” institute director Molly Lopez said. “We are fortunate we’re able to partner with 16 community mental health centers and the Texas’ Health and Human Services Commission to implement this project.”
Early psychosis refers to when an individual first shows signs of disruptive thoughts and perceptions, like delusions and hallucinations. About 100,000 adolescents and young adults in the United States experience early psychosis each year, and research shows that it is common for them to have symptoms for more than a year before receiving treatment.
Coordinated specialty care programs for early psychosis include elements such as a multidisciplinary team treatment, individualized treatment planning, low dose antipsychotic medication, family education and cognitive behavioral therapy. In the last decade, these innovative programs have expanded rapidly throughout the country. Texas currently has 28 of these teams housed in 24 community mental health centers across the state and serving more than 500 individuals every year.
EPINET-TX will leverage these programs through coordination and collaboration to support research-informed healthcare with the goals of accelerating advances in early psychosis care and recovery outcomes. The Texas network will join a nationwide partnership with already existing hubs in California, New York, Massachusetts, Minnesota, and more.
One of the focus areas of the Texas network will be substance misuse in young people with early psychosis. Research has shown that cannabis misuse, for instance, is linked to increased risk of medication non-adherence, more severe symptoms of psychosis and poorer functional outcomes. More generally, substance misuse has been linked to greater risk of psychiatric relapse, increased rates of hospitalization and more hospital days.
Through EPINET-TX, Lopez and the research team will lead a series of studies to find the best ways to address substance misuse in young people with early psychosis, with the goals of:
- Finding out whether coordinated specialty programs are successful at engaging participants in behavior change regarding substance misuse.
- Understanding the reasons that program participants continue or discontinue use of substances.
- Understanding the feasibility and acceptability of peer-led interventions for substance- use recovery.
- Developing and testing a peer-led intervention to support young people on their recovery from substance use.