Academic-Community EPINET (AC-EPINET)

Not Applicable

Recruiting

Conditions: Schizophrenia
Schizoaffective Disorder
Schizophreniform Disorders
Major Depression with Psychotic Features
Bipolar Disorder with Psychotic Features

Brief Summary: The investigators propose to examine the effects of CSC services delivered via TH (CSC-TH) versus the standard clinic-based CSC model (CSC-SD) on engagement and outcomes in a 12-month, randomized trial.

Detailed Description: 180 subjects will be randomized into a 12 month study, to one of two treatment arms. The investigators will assess four important elements of engagement to determine which are most sensitive to TH treatment and mediates effects on hospitalization rates. The investigators will assess acceptability and satisfaction of CSC-TH compared to CSC-SD, and deliver a training manual for implementing TH in CSC clinics and for use in future research. Although this study has exploratory aims consistent with pilot projects, The investigators have incorporated methodological rigor where possible (randomization, powering for hospitalization rate) in order to achieve the most robust data to assess the main study questions and inform future trials.

Recruitment & Eligibility

Inclusion Criteria

Between 16 and 35 years of age
Able to give informed consent
Willing and able to adhere to the study schedule
New intakes enrolled in one of the six clinical programs
Non-affective (schizophrenia, schizoaffective, schizophreniform) and affective (major depression with psychotic features, bipolar disorder with psychotic features) psychotic disorders with onsets within 5 years of enrollment.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
CSC-SD	Coordinated Specialty Care (CSC)	Standard clinic-based CSC model treatment. Treatment will be delivered largely in clinic for 12 months.
CSC-TH	Coordinated Specialty Care (CSC)	Telehealth based CSC model treatment. Treatment will be delivered largely through telehealth for 12 months.

Primary Outcome Measures

Name	Time	Method
Annualized hospitalization rates	12 months	To determine if CSC-TH, as compared to CSC-SD, is associated with superior clinical outcomes by counting the number of hospitalizations in a year

Secondary Outcome Measures

Name	Time	Method
Time (days) to first hospitalization	12 months	Count of the time in days to first hospitalization
Symptom and functioning outcomes assessed by the MIRECC-GAF	12 months	The MIRECC GAF is a three scale assessment of symptom severity, occupational/school functioning, and social functioning. It is scored from 0-100, with a lower score representing worse symptoms/functioning and higher scores representing better functioning. This assessment has been found to have high levels of reliability, concurrent, and predictive validity. It is completed by a trained rater and is expected to take 5 minutes to complete, as the information needed to score the participants will be gathered in various aspects of the assessment process.
Number of participants hospitalized	12 months	Count of the number of participants hospitalized (adjusted for time in treatment)

Locations (6): Prevention and Recovery Center for Early Psychosis
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Indianapolis, Indiana, United States
Early Psychosis Intervention Clinic-New Orleans (EPIC-NOLA) - Tulane University
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New Orleans, Louisiana, United States
Program for Risk Evaluation and Prevention (PREP) - University of Michigan
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Ann Arbor, Michigan, United States
Strong Ties Young Adults Program- University of Rochester Medical Center
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Rochester, New York, United States
The Early Psychosis Intervention Center (EPICENTER) at Ohio State
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Columbus, Ohio, United States
Vanderbilt's Early Psychosis Program - Vanderbilt University
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Nashville, Tennessee, United States