February 2023

Updates from the EPINET-TX State Hub

Lessons from EPINET-TX

CSC participants may leave services for many different reasons, both positive and negative. As of December 2022, 112 youth and young adults had been discharged from a CSC program. Due to the limited time collecting data in EPINET-TX, participants have not had the opportunity to receive services for the three years of the program. Therefore, data available for analysis is limited to participants leaving the program before their time in the program ends. Data on the last service date was available for 66 participants and their length of time in services is illustrated in the Figure 1.

For those participants leaving before the first 180 days of services, the most common reasons for discharge were refusing or declining services (38.9%), moving out of the service area (30.6%), and having their whereabouts unknown (19.4%). Sixty percent of those leaving services within the first 180 days were referred for other services at discharge. Sixteen percent were referred to another CSC program. Others were referred to psychotherapy, medication, substance use treatment, or care coordination.

Research Highlights

Prediction Tool for Individual Outcome Trajectories Across the Next Year in First-Episode Psychosis in Coordinated Specialty Care

Basaraba, C., Scodes, J., Dambreville, R., Radigan, M., Dachepally, P., & Gu, G. et al. (2023). Prediction Tool for Individual Outcome Trajectories Across the Next Year in First-Episode Psychosis in Coordinated Specialty Care. JAMA Psychiatry80(1), 49. doi: 10.1001/jamapsychiatry.2022.3571. Access the article.

Background: The development of reliable, validated tools using data to predict outcomes for individuals in coordinated specialty care (CSC) may be informative for person-centered decision-making. OnTrackNY is one of the regional hubs of EPINET and network of CSC sites in New York state. The sites provide CSC services to individuals aged 16 to 30 years with recent-onset (<2 years) nonaffective psychosis. Similar to Similar to EPINET-TX, researchers at OnTrackNY used individual data to predict education and employment outcomes and future psychiatric hospitalization. This study also created an data visualization tool to help inform clinicians and young persons with FEP, much like EPINET-TX will have EPIDash.

Methods: Forty-three data variables (like those collected in REDCap for EPINET-TX) from baseline and every 3-month follow-up to 24 months from 1,298 participants in the OnTrackNY program were used for analysis. Data was collected from October 2013-December 2018. The main outcome measures were education and/or employment status and psychiatric hospitalization trajectories at quarterly intervals during the first 2 years of CSC participation.

Findings:  The data was able to predict education and employment outcomes across timepoints. There was moderate predictive accuracy for psychiatric hospitalization at 3 months though predictions for future psychiatric hospitalization at 6 months and later were poor.

Limitations: OnTrackNY does not collect data after discharge from the program which limits predictions for clients post-discharge. The authors included race and ethnicity in their predictive models though there is growing evidence demonstrating racial bias in these types of data models. There is also little research into the ethical considerations for incorporating predictive tools in clinical settings, and future research needs to explore how young people and families may respond to data visualizations.

Implications for Practice

  • Data, such as that collected in REDCap for EPINET-TX, can predict education and employment outcomes for young people in CSC programs.
  • This data can be visualized for young people and providers to make decisions about care together, potentially interrupting predicted negative outcomes before they occur.
  • Another EPINET site (OnTrackNY) has already developed a data visualization tool to help young people and providers; EPINET-TX is developing a similar tool, EPIDash, which may be used to predict and improve outcomes.

Meet Loren Welles!

Meet the newest member of the EPINET-TX hub team!

Loren is a recent graduate of the M.Ed Education Policy and Planning program at UT Austin and she is very excited to join the TIEMH team! She spent last summer interning at a think tank in Washington, DC as an Archer Fellow, which piqued her interest in the intersection of schools and mental health research, policy, and evaluation. Previously, Loren worked in the nonprofit space as a program manager, taught for seven years in the public schools of Texas and Kansas, and earned degrees in music education and music performance. Outside of work, you can find her biking, playing clarinet with the Cinematic Symphony, enjoying the great outdoors, and planning her next travel adventure!

Upcoming Events and Training Opportunities
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Texas EPINET Consortium Meeting

You won't want to miss this quarter's EPINET-TX Consortium meeting. Hear what we have been learning from the research with young people and peer providers about substance use within Coordinated Specialty Care and learn next steps in this research. We also have big news on EPIDash!

March 3 at 1:00 - 3:00 PM CST

Case Conceptualization for First Episode Psychosis Series 2: Session 1: Culturally Informed Therapy for Schizophrenia

Attendees will learn how case conceptualization can inform team-based, recovery-oriented care and the foundations of three different approaches: Next up is a 3-part focus on Culturally Informed Therapy for Schizophrenia.

March 9 at 10:00 - 11:00 AM CST | Zoom Registration

2023 Texas Mental Health Creative Arts Contest

The contest aims to raise awareness of mental health experiences, challenge stigma, and provide an opportunity to express complex emotions through creative outlets. Participants may enter by submitting original, creative works in one of three categories (original artwork, writing, or photography), that draws on the contest theme “Why Does Mental Health Matter to You?” The contest is open to Texans of all ages and is judged in four age groups—elementary school, middle school, high school, and adult—across each of the three categories.

Deadline March 10th, 2023. | Enter Here

Education, Special Education, and Accommodations for Students with Psychosis: Working with Youth, Families, Teachers, and Schools

In this webinar, clinical psychologist Dr. Jason Schiffman will provide information and tangible suggestions on how to effectively work with schools, families, and students on behalf of high school students with psychosis.

March 29 at 10:00 AM - 1:00 AM CST | Register

Trauma and Psychosis Webinar Series

In this series sponsored by the American Psychological Association, participants will learn about the possible relationships between psychosis and trauma, identify approaches to collaborative treatment for co-occurring trauma and psychosis, and understand how dissociation as a trauma response can create risk for psychosis.

March 24 at 12:00 PM - 1:00 PM CST | Register

April 21 at 12:00 PM - 1:00 PM CST | Register