Early Psychosis Intervention Plus

Improving Lives Through Early Diagnosis and Treatment

Nearly 100,000 adolescents and young adults experience their first psychotic episode each year in the U.S. With half of all mental disorders manifesting by the age of 14 and 75 percent by the age of 24, the early detection and early intervention of psychosis can improve the lives of adolescents and young adults, significantly reducing the impact of mental health challenges.

“One of the main goals of early intervention is to reduce the length of time a person remains psychotic to improve their chances of a good recovery.”

Tara Niendam, Ph.D.

Executive Director, UC Early Psychosis Programs & EPI-CAL Project

Goal/Opportunity

The Early Psychosis Intervention Plus (EPI Plus) Program aspires to help improve the lives of Californians with mental health needs before those needs escalate and become severe or disabling.

The program establishes a framework for supporting collaborative efforts to shift the emphasis in California’s mental health system to early detection and intervention.

The program will identify a coordinated specialty treatment approach, evidence-based therapies, family support, medication management, and recovery-oriented practices to address psychotic symptoms and promote resilience.

Expected Outcomes

The Commission seeks to expand the provision of high-quality, evidence-based early psychosis and mood disorder detection and intervention services in California. These funds will support the goal of moving California from a stage 4 crisis response system to a stage 1 early intervention system of care.

Background

Assembly Bill 1315 (Mullin) established the Early Psychosis Intervention Plus (EPI Plus) Program and the EPI Plus Advisory Committee to advise the Commission regarding the allocation of funds for a competitive selection process to expand the provision of high-quality, evidence-based early psychosis and mood disorder detection and intervention services in the state. The Budget Act of 2019 provided the Commission with $19.5 million in one-time Mental Health Services Act (MHSA) funds to support the expansion of these programs and ensure that they operate with fidelity to an evidence-based model, commonly referred to as Coordinated Specialty Care (CSC), based on a nationally sponsored research project.

In March 2019, the Commission appointed the 13-member EPI Plus Advisory Committee as prescribed in AB 1315. In addition, the Commission sponsored a statewide conference on the EPI Plus work, which included senior leadership from the National Institute of Mental Health and representatives of a similar program in New York.

In February 2020, the Commission approved the outline of a Request for Application (RFA), based on the recommendations made by the EPI Plus Advisory Committee, which allocated $15.6 million to support existing early psychosis programs and $3.9 million to contract with the University of California, Davis as the leaders of EPI-CAL to provide training and technical assistance to grantees and other interested programs who are interested in reaching full fidelity to the CSC model over a four-year term. The Commission released the RFA in April 2020 and awarded five EPI Plus Program grants, totaling $10 million.

Due to a lack of applicants, the Commission approved the outline of a second RFA, based on the recommendations made by the EPI Plus Advisory Committee, which allocated $4 million for the expansion of new or existing early psychosis programs, $1 million for public awareness as well as increasing workforce development and retention, and $600,000 for research initiatives that identify barriers and improve access to care. The Commission released the second RFA in February 2021 and awarded two additional EPI Plus Program grants in April 2021. The seven awardees are listed below:

• Kern County Behavioral Health Department
• Lake County Behavioral Health Department
• San Francisco County Behavioral Health Department
• Santa Barbara County Behavioral Health Department
• Sonoma County Behavioral Health Department
• Santa Clara County Behavioral Health Department
• Nevada County Behavioral Health Department (hub) & Colusa and Mono Counties (spokes)

Project Milestones

2019

17 Mar

First Advisory Committee Meeting

The first meeting of the EPI Plus Advisory Committee is convened.

14 Jun

Members of the Advisory Committee Appointed

Members of the Advisory Committee are appointed.

22 Aug

Statewide Vision Presented

Dr. Thomas R. Insel, co-founder and president of Mindstrong Health, presents a statewide vision to the Committee.

23 Aug

AB 1315 Bill Establishes EPI Plus Program

Assembly Bill 1315 establishes the EPI Plus Program and the EPI Plus Advisory Committee.

2020

01 Jan

EPI Plus Advisory Committee Meeting

The EPI Plus Advisory Committee developed strategies for the allocation of funds.

27 Feb

Commission Approves First RFA Outline

The Commission approves the first RFA outline which allocated $15,562,000 to fund EPI Plus Program grants and $3,890,000 to provide training and technical assistance.

20 Apr

First RFA Released

The Commission releases the RFA in a competitive bid process.

01 Aug

Highest Scoring Applicants Determined

Kern, Lake, San Francisco, Santa Barbara, and Sonoma Counties receive the highest scores.

27 Aug

First Notice of Intent to Award

The Commission notifies all applicants of its intent to award grant funds to the following five applicants:

Kern - $1,999,924
Lake - $1,999,996
San Francisco - $2,000,000
Santa Barbara - $2,000,000
Sonoma - $1,996,144

05 Oct

Allocation of Remaining Funds

The EPI Plus Advisory Committee reconvenes to consider options for allocating the remaining funds and to provide the Commission with a recommendation.

09 Nov

Allocation of Remaining Funds

The EPI Plus Advisory Committee reconvenes to consider options for allocating the remaining funds which included utilizing some of the funding to focus on addressing racial disparities.

19 Nov

Commission Approves Second RFA Outline

The Commission approves the second RFA outline which allocated $4 million in additional grant funds for new or existing applicants, $1 million for workforce expansion and public awareness, and $565,966 for research into barriers to accessing care for diverse communities.

2021

05 Feb

Second RFA Released

The Commission releases the second RFA with a focus on reducing racial disparities and supporting minority communities that experience inequalities in accessing early psychosis care.

22 Apr

Second Notice of Intent to Award

The Commission notifies all applicants of its intent to award grant funds to the following two additional applicants:

Santa Clara - $1,736,270
Nevada County (hub) & Alpine and Mono Counties (spokes) - $1,991,514

17 May

TTA Contract Executed

The Commission executes a contract with UCD to commence EPI Plus Training and Technical Assistance (TTA) planning activities.

13 Sep

Grant Agreements Executed

The Commission executes grant agreements with the seven EPI Plus Program grantees.

Next Steps

Refine Strategy for Remaining Funds

Reconvene the EPI Plus Advisory Committee to refine the strategy for funding workforce expansion, public awareness, and research on barriers to accessing care for diverse communities.
Explore Public/Private Partnerships

Explore partnership opportunities for private insurance support of early psychosis programs and for the collection and evaluation of data.
Develop Statewide Training and Technical Assistance Program

Promote the EPI-CAL statewide training and technical assistance program based upon a standardized curriculum to ensure the consistency and reproducibility of outcomes across counties.

Reach out to learn more about Early Psychosis Intervention Plus

Events

Feb 14Meeting with Assemblymember Arambula’s Office and UC Davis

Resources

Visit the EPI-CAL website