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Early Psychosis Intervention

Spreading Evidence-based 


A First Episode Psychosis (FEP) is one of the most frightening and disabling experiences from which a young person can suffer. Onset occurs in nearly all cases in youth and emerging adults (YEA), a crucial transition time, when major developmental milestones (high school graduation, first intimate relationship, maturation of executive function) occur. An FEP typically occurs in the context of diagnoses of schizophrenia, schizoaffective disorder, substance-induced psychosis, and psychotic bipolar disorder, which when taken together are the most disabling disorders (among all medical illnesses) for YEA.

The Enhancing Evidence-Based Practice for Youth and Emerging Adults with Early Psychosis: Implementation and Evaluation in Diverse Service Settings (EPI-SET) study focuses on implementing NAVIGATE, a coordinated and comprehensive multidisciplinary treatment program for FEP that is deliverable in community mental health settings. Although Ontario already has early psychosis intervention (EPI) programs, our team’s recent work has identified major challenges of delivering coordinated care, particularly those elements of care that enhance recovery. These challenges also exist nationally and internationally.


By building on the already existing EPI community of practice through the Early Psychosis Intervention Ontario Network (EPION), we will implement NAVIGATE with the help of CAMH’s Provincial System Support Program facilitators. The use of tele-videoconferencing through ECHO Mental Health Ontario, provides us with an opportunity to ensure sustainability.


Using health administrative data held at the Institute for Clinical Evaluative Sciences (ICES), we are examining system-level outcomes, including hospitalizations, emergency department visits, outpatient physician visits and health care costs of YEA suffering from a FEP who are treated with NAVIGATE compared to those treated in EPI programs without NAVIGATE and to those not treated by EPI programs. 


1.  Assess whether implementation of NAVIGATE leads to improvement in fidelity to EPI standards of care.​

2.  Compare system-level outcomes and system costs among patients receiving NAVIGATE compared to patients
  at other EPI sites not receiving NAVIGATE and patients with psychotic disorders not enrolled in EPI.

3.  Determine longitudinal change in functioning and symptoms in NAVIGATE patients.

4.  Evaluate patient and family member engagement according to the SPOR framework.
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