Coordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.

In 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.

N=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.

The implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.

Supported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

There is wide consensus that the combination of psychopharmacology and psychotherapy is superior to either approach used alone, in managing depressive, anxiety and psychotic disorders. Completing homework assignments are prerequisite for successful outcomes in psychotherapy. The convergence of digital computer technology and consumer self-empowerment have generated a bewildering array of mental health applications for smartphones and other mobile devices. The purpose of the present poster is to review available apps of interest for patients with early psychosis.

A search was recently conducted of the stores on the iOS and Android platforms, seeking apps for mood, anxiety, psychotic and cognitive disorders. Reviews of digital technology resources provided by the International Mental Health Research Organization (IMHRO) at www.psyberguide.org were consulted. Criteria for inclusion included: (1) popularity measured by greater than 10,000 downloads (2) a score of 3.5 or higher on the Mobile Apps Rating System (MARS) and (3) acquisition cost less than $1. Consumer reviews were scanned. A total of 7 apps were culled from an expanding universe of thousands. This included top-rated apps in each of three symptom domains: depression, anxiety and cognitive disorders. Ranked in order of MARS rating the leading depression apps were “Depression CBT Self-Help Guide” and “eCBT Mood”. The most popular anxiety apps were “Stop Panic & Anxiety” and “Headspace”. The top apps for cognitive enhancement training were “Brain HQ” and “Fit Brains Focus”. In addition, the suicide prevention app “My3” was included because of its life saving potential. Consumers have rated the reviewed apps favorably. Conclusion: Smartphone apps are achieving wide acceptance in self-management of common psychiatric disorders. Clinicians need to become familiar with these adjunctive therapeutic tools, and integrate them in brief psychopharmacology visits.

No funding.