Early Psychosis Intervention Plus

Shifting the emphasis of the mental health system to the early detection of mental disorders and intervention

Improving Lives Through Early Diagnosis and Treatment

Nearly 100,000 adolescents and young adults experience their first psychotic episode each year in the United States. 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) & Alpine and Mono Counties (spokes)

Project Milestones

Next Steps

  1. 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.

  2. Explore Public/Private Partnerships

    Explore partnership opportunities for private insurance support of early psychosis programs and for the collection and evaluation of data.

  3. 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