NIMH recently established the Early Psychosis Intervention Network (EPINET), which includes five regional scientific hubs, nearly 60 early psychosis clinical service programs, and the EPINET National Data Coordinating Center (ENDCC; see announcement here.) The regional scientific hubs support practice-based research to improve early identification, diagnosis, clinical assessment, intervention effectiveness, service delivery, and health outcomes in clinics offering evidence-based specialty care to persons in the early stages of psychotic illness. This Funding Opportunity Announcement (FOA) invites applications for additional regional scientific hubs to join the overall EPINET effort. For this FOA, “early psychosis” is defined as the period spanning the onset of an affective or non-affective psychotic disorder and up to 5 years following the first episode of psychosis (FEP). Each new EPINET regional scientific hub will link multiple early psychosis clinical service programs through (a) standard measures of early psychosis clinical features, services, and treatment outcomes; (b) informatics tools to collect de-identified, person-level data across sites; and (c) a unified approach for aggregating and analyzing pooled data. Large, integrated datasets are expected to facilitate rigorous quality improvement and program evaluation efforts within regional networks. In addition, each regional scientific hub will propose one or more mental health services and intervention research projects to advance the learning health care goals of measurement-based treatment, continuous improvement and innovation in care delivery, and practice-based research to drive the process of scientific discovery. New regional scientific hubs selected for funding will collaborate closely with the ENDCC as described in funding announcement RFA-MH-19-151.
In 2008, the National Institute of Mental Health (NIMH) announced the Recovery After an Initial Schizophrenia Episode (RAISE) initiative, which called for research to investigate the feasibility and effectiveness of early intervention services for first episode non-affective psychosis in the United States. The RAISE Early Treatment Program randomized controlled trial demonstrated the superiority of team-based, multi-component treatment for improving quality of life, symptoms, and functioning among persons with FEP, compared to usual care. The RAISE Connection Program implementation study reported similar outcomes for treated individuals and produced practical tools for introducing and maintaining research-based practices in community settings. Today, over 280 specialty care programs for FEP operate in 49 states, many based on the Coordinated Specialty Care (CSC) model tested in RAISE. These programs share several common features, including a collaborative, recovery-oriented treatment philosophy, multidisciplinary team structure, and commitment to high quality, evidence-based services that address the needs of youth experiencing FEP. While most programs restrict eligibility to recent-onset, non-affective psychosis (i.e., less than 2 years of illness), other clinics extend eligibility to persons with affective psychosis and/or up to 5 years illness duration. NIMH intends to commit $4.5 million in FY 2020 to fund up to three new awards.
In 2015, NIMH introduced the concept of an Early Psychosis Intervention Network (EPINET) among treatment centers that offer evidence-based specialty care to persons experiencing early symptoms of psychosis. EPINET links clinical sites through standard clinical measures, uniform data collection methods, data sharing agreements, and integration of participant-level data across service users and settings. Systematic analysis of pooled data will inform clinics’ quality improvement and program evaluation efforts, and will accelerate research into psychosis risk factors, indicated prevention, service delivery models, and personalization of care. These goals are consistent with the Institute of Medicine vision of learning health care in which health systems provide effective treatments, evaluate care processes and outcomes systematically, strive for continuous improvement and innovation in care delivery, and utilize data collected in clinical practice to drive the process of scientific discovery.
EPINET presents a unique opportunity for accelerating practice-based research into treatment approaches for early psychosis in the U.S., i.e., encouraging collaborations among service users, front-line clinicians, health care administrators, and scientific content experts to conduct high-quality clinical research in real-world settings. This perspective is consistent with Research Strategies 3.3 and 4.2 from the NIMH Strategic Plan for Research, which focus on testing interventions for effectiveness in community practice settings and establishing research-practice partnerships to improve implementation of evidence-based mental health services, respectively. NIMH intends to commit $4.5 million in FY 2020 to fund up to three new awards. Direct costs are limited to $1 million in any one year. The maximum project period is 4 years.
Filed Under: Funding Opportunities