Evaluating and sustaining Coordinated Specialty Care for a recent onset of psychosis in non-academic-affiliated community mental healthcare settings

Vanessa V Klodnick; Ariel Brenits; Rebecca P Johnson; Deborah A Cohen; Margaret Ann Pauuw; Eva Zeidner; Marc A Fagan

doi:10.1016/j.evalprogplan.2023.102268

Evaluating and sustaining Coordinated Specialty Care for a recent onset of psychosis in non-academic-affiliated community mental healthcare settings

Eval Program Plann. 2023 Jun:98:102268. doi: 10.1016/j.evalprogplan.2023.102268. Epub 2023 Feb 28.

Authors

Vanessa V Klodnick¹, Ariel Brenits², Rebecca P Johnson³, Deborah A Cohen⁴, Margaret Ann Pauuw⁵, Eva Zeidner⁶, Marc A Fagan⁶

Affiliations

¹ Thresholds Youth & Young Adult Services Research, & Innovation, Chicago, IL, USA; The University of Texas at Austin, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, USA. Electronic address: Vanessa.Klodnick@thresholds.org.
² Thresholds Evaluation, Chicago, IL, USA.
³ Thresholds Youth & Young Adult Services Research, & Innovation, Chicago, IL, USA.
⁴ The University of Texas at Austin, Texas Institute for Excellence in Mental Health, Steve Hicks School of Social Work, USA; Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
⁵ Loyola University of Chicago, School of Social Work, USA.
⁶ Thresholds Youth & Young Adult Services, Chicago, IL, USA.

PMID: 36931120
DOI: 10.1016/j.evalprogplan.2023.102268

Abstract

Purpose: To improve sustainability of Coordinated Specialty Care (CSC) for a recent onset of psychosis, a better understanding is needed regarding how non-academic-affiliated community mental health centers blend CSC service elements and select key performance metrics to evaluate their approach.

Methods: A quality and evaluation team embedded within a large community mental health center partnered with CSC site leadership to implement CSC and design a program evaluation strategy informed by CSC research literature. Clinical, family, vocational, and psychiatry services participation, exits, key performance indicators, and standardized measures were examined for participants (n = 47) enrolled for 12-months.

Results: Mean service participation was 55 h (SD = 23.5) in the first 12-months (approximately 4.70 h/month). All participated in clinical; 87% in psychiatry; 67% in vocational; and 57% in family services. Sixty-one percent had planned service exits; 39% had unplanned exits. Across the 12-months, 83% were employed or in school; 72% were not psychiatric hospitalized.

Conclusions: CSC participation and outcomes were similar to the limited research examining both together. Understanding service participation and provider adjustments to sustain CSC is critical in community mental healthcare settings that rely on fee-for-service billing mechanisms. Findings have implications for national CSC data harmonization and sustainability efforts.

Keywords: Community mental health; Coordinated Specialty Care; First-episode psychosis; Program evaluation; Service participation.

MeSH terms

Community Mental Health Centers
Humans
Mental Health Services*
Program Evaluation
Psychotic Disorders* / psychology
Psychotic Disorders* / therapy
Schools