Implementation of Early Psychosis Intervention Program ... - EENet

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49Chart 6: Wellness/recovery plans: Implementation* relative to other elements (Q70)standard elementsPublic educationEarly referralWellness plansGraduat ionOutreach andFamily educationPhysical healthFamily supportWorking with IP unitsCrisis managementFamily role in assessmtClient psycho-educationAccess to psy assessmtResponse timesAntipsychotic meds useRelapse prevention0 20 40 60 80 100% of sites reporting implementation 'most of the time'* % programs reporting implementation ‘most of the time’ versus ‘some of the time’ or ‘not too often’.Table 12: Wellness/recovery plans: Implementation by program typeSurvey Question Response All Large Small Hospital CommunitySitesQ70: How often able to% sites implementing 45 50 38 57 29implement this element‘most of the time’Q71: Have written procedure % yes 41 37 48 43 38Large: catchment area population > 100,000 population (31 program sites)Small: catchment area population < 100,000 population (21 program sites)Hospital: hospital is parent organization (30 program sites)Community: community agency is parent organization (22 program sites).Main challenges to developing wellness/recovery plans noted by programs:o Client circumstances (e.g., readiness, attendance, engagement, wellness).o Staffing, time and resource constraints.o 4 week timeframe-client may still be experiencing symptoms at 4 weeks; staff may not knowclient well enough at 4 weeks to develop meaningful plan.o Lack of standardized program approach for regularly generating and reviewing plans.Strategies suggested by programs for developing wellness/recovery plans:o Using OCAN as part of wellness plan.o Systematic program procedures (e.g., regularly review plan with clinical team).o Client engagement-provide education so development of wellness plan can be collaborative.o Involve other organizations as relevant to developing/implementing wellness plan (e.g.,addiction services, crisis services).What would help programs to develop wellness/ recovery plans:o Standardized processes and tools (e.g., development of an electronic user-friendly template;computer system reminders when plans are due; development of recovery plan specific toEPI).
50o Team processes (e.g., regular team meetings to develop/discuss care plan, lower caseloads).o Regular contacts with clients for ongoing monitoring.2. Outreach and client engagementStandard 3 sets out the expectation that EPI programs use proactive outreach strategies such as inhome visits, outreach to families, and services provided as part of recreational opportunities inthe community, with the goal of keeping clients engaged in treatment, and reducing missedappointments and program drop-out.Summary of Results:o Lower frequency of implementation with only 63% of sites overall reporting using proactiveoutreach for client engagement ‘most of the time’.o Small programs and community agency sponsored programs were more likely than theircounterparts to indicate higher implementation (71% versus 57%, and 76% versus 53%respectively able to implement most of the time)o Across all sites, approximately half of all client face-to-face contacts occurred in offices withthe remainder in community locations. Hospital sponsored sites reported somewhat higherrate of office contacts (60%) (Table 13).o Organizational policies may limit staff use of some outreach strategies such as transportingclients in staff vehicles, conducting home visits, and mobile devices/e-communications toconnect with clients.o Time was also noted as a limitation to outreach, especially in more rural areas where longerdistance travel is required.Chart 7: Outreach and client engagement: Implementation* relative to other elements (Q74)Public educationEarly referralWellness plansGraduat ionOutreach andFamily educationPhysical healthFamily supportWorking with IP unitsCrisis managementFamily role in assessmtClient psycho-educationAccess to psy assessmtResponse timesAntipsychotic meds useRelapse preventionstandard elements0 20 40 60 80 100% of sites reporting implementation 'most of the time'* % programs reporting implementation ‘most of the time’ versus ‘some of the time’ or ‘not too often’.
Page 1 and 2: Implementation of Early Psychosis I
Page 3 and 4: 2Table of ContentsTable of Contents
Page 5 and 6: 4Key MessagesSurvey Participationo
Page 7 and 8: 6Implementation Supportso Most site
Page 9 and 10: 8Executive SummaryIntroductionBackg
Page 11 and 12: 10The graph below reports global pe
Page 13 and 14: 122. Family involvement in assessme
Page 15 and 16: 143. Anti-psychotic medications tre
Page 17 and 18: 16Standard 4 Results: Psychosocial
Page 19 and 20: 18Main Report“It is now well appr
Page 21 and 22: 20agreement; low caseloads (10 to 1
Page 23 and 24: 22developed by the National Health
Page 25 and 26: 24IISurvey OverviewBackgroundIn 201
Page 27 and 28: 26Figure 2: Survey participation re
Page 29 and 30: 28IIISurvey ResultsResults are repo
Page 31 and 32: 30Table 1B: Program details by spon
Page 33 and 34: 32Standard 1: Facilitating Access a
Page 35 and 36: 34o Outreach most often included pr
Page 37 and 38: 36Summary of Results:o Only 31% of
Page 39 and 40: 38o Overall, 40% of programs had a
Page 41 and 42: 40Standard 2: Comprehensive Client
Page 43 and 44: 42What would help programs to meet
Page 45 and 46: 443. Access to psychiatric assessme
Page 47 and 48: 46o More funding and more consisten
Page 49: 48Standard 3: TreatmentThe survey e
Page 53 and 54: 52o Using social media and youth fr
Page 55 and 56: 54Table 16: Procedures and protocol
Page 57 and 58: 56o In addition, some programs note
Page 59 and 60: 58Table 19: Working with inpatient
Page 61 and 62: 60Table 20: Client and family psych
Page 63 and 64: 62Approaches used by programs for c
Page 65 and 66: 64o Difficulties with client and fa
Page 67 and 68: 66Standard 4: Psychosocial Support
Page 69 and 70: 68Main challenges to providing psyc
Page 71 and 72: 70Table 29: Family education and su
Page 73 and 74: 72Standard 6: Graduation from the P
Page 75 and 76: 74o An alumni program and services,
Page 77 and 78: 76Topics for Further InvestigationT
Page 79 and 80: 78McGorry, P. (2012). At issue: Coc
Page 81 and 82: 80HealthThorold 4 Early Interventio
Page 83: 82Englehart,Kirkland Lake,New Liske

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