Vinod H. Srihari1,2, Maria Ferrara1,2, Fangyong Li3, Shadie Burke1,2, Emily Kline4,5, Jessica M. Pollard1,2, John D. Cahill1,2, Sinan Guloksuz6, Glen McDermott7, Scott W. Woods1, Larry Seidman4,5, Matcheri Keshavan4,5; 1Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA, 2Program for Specialized Treatment Early in Psychosis (STEP), New Haven, CT, USA, 3Yale Center for Analytical Sciences, Yale School of Public Health, 4Harvard Medical School, 5Program for Prevention and Recovery in Early Psychosis (PREP), Boston, MA, USA, 6Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, the Netherlands, 7Red Rock Branding, New Haven, CT, USA
BACKGROUND: The Specialized Treatment Early in Psychosis (STEP) program has delivered coordinated team-based first-episode services (FES) since 2006 in New Haven. In 2015, STEP launched a 4-year early detection (ED) campaign (Mindmap), adapted from the Scandinavian TIPS approach, to shorten Duration of Untreated Psychosis (DUP) in a 10-town catchment (population 400,000). METHODS: Mindmap’s social-ecological model targets demand (delays in identifying illness and help-seeking) and supply (delays in referring to and providing FES) side constituents of DUP. Mindmap uses mass and social media messaging, professional detailing, and rapid triage of referrals. DUP is classified as the time between the onset of psychosis and initiation of antipsychotic treatment (DUP1) and FES care (DUP2). A control FES (PREP, Boston) supports the quasi-experimental design. The campaign was launched in 2015, after a one-year baseline. A selective interim analysis follows. RESULTS: The number of help-seeking attempts (HSAs) varied between 1-24, without a statistically significant reduction at STEP: median (Quartile 1- Quartile 3): 2 (1-3) at baseline vs. 1 (1-2) at 32mos (p=0.19). DUP1 trended downward at STEP: median (Q1-Q3): 153 (17 – 339) days at baseline to 40 (15-141) days at 32mos (p=0.06). No significant reduction in DUP2 at STEP is yet evident: median (Q1-Q3): 332 (52 – 521) days at baseline to 184 (62-470) days at 32mos (p=0.70). At PREP both DUP1 & DUP2 remain unchanged and comparable to baseline levels at STEP. CONCLUSION: Mindmap has shown promise in reducing delays to care. Additional measures of impact with comparisons across sites will be presented.
