The impact of COVID-19 on coordinated specialty care (CSC) for people with first episode psychosis (FEP): Preliminary observations, and recommendations, from the United States, Israel and China

ABSTRACT

In the wake of COVID-19, mental health providers and treatment programs are adapting rapidly to the challenges in engaging people and delivering treatment with limited guidance. This paper will explore the challenges associated with delivering treatment within coordinated specialty care (CSC) programs for people with first episode psychosis. Suggestions for treatment will take into consideration experiences with stress, changes to the pursuit of work and school, and increased time spent with families. Drawing on the experience of several CSC programs in the United States, Israel, and China, we describe the impact and modifications to the core treatment elements in CSC including medication, family interactions, supported employment and education, individual therapy, peer support and the way they are delivered. The paper includes recommendations based on experiences from CSC programs to help staff members, participants, and family members better identify, prepare, cope and respond to the unique new challenges and suggests modifications that can be made during various stages of the coronavirus pandemic.

KEYWORDS:

• COVID-19
• first episode psychosis
• treatment recommendations
• coordinated specialty care

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Piper S. Meyer-Kalos

Piper S. Meyer-Kalos is an Assistant Professor, Developer and Trainer for the NAVIGATE program for persons with first episode psychosis. Her research focuses on the development of psychosocial interventions for persons with serious mental illness and the integration of positive psychology and recovery in treatment.

David Roe

David Roe is a Professor and his research focuses on the psychosocial processes of recovery from serious mental illness, stigma, routine outcome measurement (ROM), and the evaluation of interventions and services.

Susan Gingerich

Susan Gingerich is an independent trainer and consultant for the NAVIGATE program for persons with first episode psychosis and the Illness Management and Recovery interventions for persons with serious mental illness.

Kate Hardy

Kate Hardy is a clinical assistant professor and trainer who has significant experience in providing CBTp to individuals with early psychosis, and those at risk of developing psychosis, in both individual and group settings and integration of this clinical intervention to broader systems and staff teams. She has led multiple trainings and workshops in CBTp to a wide variety of audiences including community clinicians, psychiatrists, and families, and provides ongoing supervision and consultation in this approach.

Iruma Bello

Iruma Bello is an Assistant Professor and Training Director of OnTrackNY at the Center for Practice Innovations within the Division of Behavioral Health Services and Policy Research at Columbia University.

Debra Hrouda

Debra Hrouda is a Clinical Associate Professor and Director of Practice Implementation and Evaluation at the BeST Center.

Daniel Shapiro

Daniel Shapiro specializes in the identification and treatment of those at-risk for or in the early stages of psychosis. He also has clinical and teaching expertise in cognitive behavioral therapy, particularly for mood, anxiety, psychosis, and trauma-related concerns in adults and adolescents. His research involvement centers on the evaluation of approaches to identifying and treating those in the earliest stages of psychosis, with the goal of delaying or preventing mental illness and any difficulties or distress that can come with symptomatic or at-risk states.

Katherine Hayden-Lewis

Katherine Hayden-Lewis is the Rural Services Director at the EASA Center for Excellence. Her work focuses on FEP clinical, training, fidelity, engagement and programmatic adaptations for rural and frontier community sites. Her research explores authentic identity development in young people with FEP and the associated clinical training and implications for policy.

Liping Cao

Liping Cao is a psychiatrist, the Director of Early Intervention Services in the Affiliated Brain Hospital of Guangzhou Medical University and at the South China Mental Health Early Intervention Alliance. Her clinical work focuses on the early intervention for FEP and mood disorders, and her research explores the biomarkers for the early intervention of bipolar disorder.

Xiaoyu Hao

Xiaoyu Hao is a psychotherapist in the Department of Child and Adolescent and the executive director of FEP early intervention program in Guangzhou. Her work focuses on the family therapy for patients with serious mental illnesses.

Yanbin Liang

Yanbin Liang is a Psychotherapist in the Rehabilitation Department. His work focuses on IRT for person with FEP.

Siqian Zhong

Siqian Zhong is a Psychotherapist in the Early Intervention Department, who is in charge of case management in our FEP program.

Kim T. Mueser

Kim T. Mueser is a Professor and his clinical and research interests include FEP, family psychoeducation, the treatment of co-occurring psychiatric and substance use disorders, psychiatric rehabilitation for serious mental illnesses, and the treatment of posttraumatic stress disorder.