This study is testing a new approach to help people with first episode psychosis transition successfully from the hospital to outpatient mental health care. Many patients lose contact with services after they leave the hospital, which can lead to worse outcomes. The investigators have developed a Transition Care Team (TCT) that works with patients while they are in the hospital and continues to support them after discharge. The team provides therapy, case management, and coordination with community programs that offer ongoing care. The main goal of the study is to find out if this new program increases the number of patients who successfully begin outpatient treatment after hospitalization, compared to usual care. The investigators will also look at whether the program improves symptoms, functioning, and overall well-being.
Diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depressive disorder with psychotic features, schizophreniform disorder, or psychosis NOS
The diagnosis of one of the psychotic disorders has a duration of less than two years.
Able to read, speak, and understand English, which will be assessed through observation.
Able and willing to provide written informed consent or assent, in cases where caregivers are considered legal guardians. Dr. Shima, co-I of the study, is a forensic psychiatrist, and particularly adept at judging such ability. Drs. Erickson and Keedy have conducted studies in individuals with psychotic disorders, including FEP and in the context of clinical trials, for years, and are similarly competent to judge whether individuals can provide informed consent. Finally, we will also use an Evaluation to Sign Consent form that documents subjects' verbalized understanding of key aspects of the study.
Individuals with substance-induced psychosis or psychosis due to a medical condition will not be included in the study. We will use the Structured Clinical Interview for DSM-5 as well as medical records, and if the subject gives permission, caregiver information in this process
Individuals who do not meet criteria for a first episode of psychosis
Subjects will be recruited from those admitted to the psychiatry units in the Wyman Gordon building at University of Chicago Ingalls Memorial hospital.
Other
Prospective
Transition Care Team
BehavioralThe novel intervention is the Transition Care Team (TCT), a multidisciplinary clinical support model designed to improve continuity of care for individuals experiencing a first episode of psychosis. The TCT provides short-term post-discharge services, including psychoeducation, case management, peer support, and coordination with outpatient programs until participants are established in Coordinated Specialty Care (CSC). This differs from standard care, where patients typically receive discharge referrals without structured follow-up. The intervention itself uses evidence-based clinical practices but applies them in a new, transitional format for this population, which is not currently part of standard inpatient-to-outpatient care at UChicago or Ingalls.
Effectiveness of Transition Care Team for First Episode Psychosis
Attendance at 1 or more than 1 CSC appointment within 6 weeks of discharge
Demographic Factors affecting CSC Engagement
Assessing mechanisms underlying effectiveness of CSC engagement by dividing subjects into those that did attend CSC and those that did not and compare the demographic \[sex, age, socioeconomic status\] data of patients.
Symptom Severity/BPRS Score
Assessing mechanisms underlying the effectiveness of CSC engagement by dividing subjects into those that did attend CSC and those that did not attend and compare the symptom severity (BPRS score) at the patient-level.
Barriers to Engagement
Assessing mechanisms underlying effectiveness of CSC engagement by dividing subjects into those that did attend CSC and those that did not attend and compare the needs (family support) and system-level variables including transportation, insurance, etc. that are barriers that can affect attendance.
Click on the lead sponsor to view all of their trials.
University of Chicago
Lead sponsor
Sidney R. Baer, Jr. Foundation
Collaborator
