Psychosis is typically identified in adolescence or early adulthood and can cause chronic impairment throughout life. Duration of untreated psychosis (DUP) is one modifiable factor that predicts clinical and functional outcomes. Shorter duration of untreated psychosis has been associated with a host of positive outcomes. Despite this knowledge, DUP in the United States is too long. Prior efforts to reduce DUP have met with only modest results, possibly because outreach efforts have targeted the wrong stakeholder groups. Social workers constitute the majority of the human services and mental health workforce and represent a segment of the workforce likely to have direct contact with people in the early phases of psychosis. Therefore, social workers would be an ideal group to engage towards the goal of reducing DUP. In the context of a randomized controlled trial, in partnership between the Maryland Early Intervention Program (a network of specialty clinics for early psychosis) and the University of Maryland School of Social Work, we propose to administer an innovative online training program that emphasizes screening implementation to a large network of over 1,200 clinical social workers. The project is designed to increase awareness of early psychosis among social workers and to thereby facilitate rapid access to specialty care for their clients who may be experiencing first episode psychosis, circumventing the extended DUP that is characteristic of current treatment as usual. We expect at least 300 new referrals for early psychosis treatment through this intervention, which would give us sufficient statistical power to detect improvements in DUP, referral rate, and referral validity. The proposed intervention will take advantage of the research team's access to social workers across the state, as well as an expertise in psychosis screening, to systematically test training and screening methods intended to reduce the duration of untreated psychosis in our community.
Duration of untreated psychosis has emerged as an important, modifiable prognostic factor impacting meaningful outcomes for the treatment of individuals with psychosis. This project proposes to engage social workers, the nation's largest human services and mental health workforce, to use screeners to identify psychosis early and facilitate rapid specialty treatment.
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