Early Detection and Intervention for the Prevention of Psychosis

The Program Being Evaluated

The Foundation's initiative, National Demonstration of Early Detection, Intervention and Prevention of Psychosis in Adolescents and Young Adults (EDIPPP), was designed to replicate the Portland Identification and Early Referral (PIER) Program that uses evidence-based psychosocial and pharmacologic interventions in the early identification and treatment of adolescents and young adults with severe mental illness. Recognizing that the community can play an important role in prevention, EDIPPP reaches out to adults who have regular interaction with young people (teachers, social workers, doctors, nurses, police officers, parents) and educates them on early signs of psychotic illness so that they can identify those at risk. EDIPPP works primarily with young people ages 12 to 25 who show early symptoms but do not yet have the disease and provides them with treatment plans based on their level of need. By leveraging early referral programs, EDIPPP holds the promise of redefining mental health services and redirecting the course of treatment to prevent psychotic illness in young people.

About the Evaluation

Led by Brenda Joly, Ph.D., University of Southern Maine, Edmund S. Muskie School of Public Service, this project will evaluate the education and community outreach efforts of this initiative over four years. It will assess three major areas: (1) implementation of the PEI education and community outreach strategies, (2) contextual factors that may influence the implementation and impact of this initiative, and (3) specific outcomes related to the PEI education and outreach efforts.

Summary of Methods

Process and outcome measures will be used to obtain qualitative and quantitative data. Data were collected from focus groups, interviews and survey.

Knowledge and Impact

Year One Findings

  • Outreach and training efforts are reaching the intended audiences. The sites have clearly been providing training and outreach activities designed to increase referrals; one of the major outcomes of their efforts. To date, there is strong evidence to suggest that the outreach efforts have focused, in large part, on personnel in the fields of education, mental health and primary care. This is consistent with the priority audiences identified in the outreach framework.
  • More than any other method, referrers to EDIPPP first learned about the program through a community presentation or training.
  • Participants in the EDIPPP trainings reported statistically significant changes in their attitudes and knowledge as a result of the training.
  • Both community members and the training audience affirmed the credibility of the program. This finding supports the cornerstone of the EDIPPP’s approach—create a positive reputation so that the community will feel comfortable making referrals.
  • Analyses based on the Theory of Planned Behavior indicated that a training participant’s plan to make a referral to EDIPPP was partly influenced by his or her attitude toward EDIPPP and whether he or she perceived that he or she had adequate opportunity to make a referral. Intentions also were associated with overall training satisfaction. EDIPPP trainings that address these areas may increase the likelihood that a participant will refer in the future.
  • EDIPPP operates in different community and policy contexts. The variation among EDIPPP sites is apparent in several areas. Key informant and focus group discussions confirmed cultural variation in the local communities, as well as revealed differences at the state level. Some states were launching prevention campaigns and policy changes that would support local EDIPPP efforts.