Implementation of Early Psychosis Intervention Program ... - EENet

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73Table 32: Client referrals as part of discharge planning (Q 133)Where are clients referred post discharge % programs referring clients often to …Case management 31PC providers only 29Outpatient psychiatry 25College or university MH services 8Other community MH agency 8Other comm. addictions agency 6ACT team 4Main challenges to client graduation within 3 years noted by programs (Table 33):o Programs noted lack of appropriate alternatives (67% of sites), clients not being ready toleave (65%) and staff not ready to let go (12%).o Specific challenges noted:o Difficulty transferring clients to new services due differences in care, inconsistent followupor loss of contact with client.o Clients who do not meet eligibility criteria for other services or the referral process isunclear, complex or lengthy.o Long wait times for other services, especially community services, case management, andpsychiatry.o Also noted were concerns about relapse.Table 33: Reasons clients stay longer than 3 years (Q 132)Reasons clients stay > 3 yrs. % yesLack of appropriate alternatives 67Clients not ready to leave 65Staff not ready to let go 12Strategies suggested by programs for client graduation:o Planning ahead with clients and their families, which can be done using a discharge protocoland providing written materials to support the protocolo Beginning referrals in advance of discharge.o Alumni program activities, either through a graduation celebration for clients and peersupport opportunities or by using a shared-care model with PC physicianso Programs provide consultation support (some for more than a year) to providers who areworking with discharged clients, and 1/4 offer an alumni program, although no sites in smallcatchment area sizes offer this option.What would help programs with client graduation:o Almost all programs (87%) said that more services for graduating clients would help theirdelivery of EPI.o Access to information about community resources, for example a centralized access registryof community providers accepting graduated clients.o Peer support workers who can help clients with the transition process.
74o An alumni program and services, which could include recognition ceremonies and the abilityto buy graduation gifts or provide a “step down” period similar to Assertive CommunityTreatment (ACT).o Flexibility in the EPI Standards, such as having more time before clients need to graduate,having a formal process to creating an alumni program, establishing criteria for connection.o Improved collaboration between EPI program and community services.o More capacity re: appropriate services, especially in the community, for example, a youngadult ACT team and more recovery-based and family friendly services.
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Implementation of Early Psychosis I
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2Table of ContentsTable of Contents
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4Key MessagesSurvey Participationo
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6Implementation Supportso Most site
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8Executive SummaryIntroductionBackg
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10The graph below reports global pe
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122. Family involvement in assessme
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143. Anti-psychotic medications tre
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16Standard 4 Results: Psychosocial
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18Main Report“It is now well appr
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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 and 50: 48Standard 3: TreatmentThe survey e
Page 51 and 52: 50o Team processes (e.g., regular t
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: 72Standard 6: Graduation from the P
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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