About EPI-SET

Implementation of ‘NAVIGATE’ in Ontario aims to help youth and emerging adults (YEA) suffering from a first episode of psychosis (FEP). 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 can examine system-level outcomes, including hospitalizations, emergency department visits, and outpatient physician visits of YEA suffering from a FEP who are treated with NAVIGATE compared with those treated in EPI programs without NAVIGATE and those who are not treated in EPI programs. In addition, we can also evaluate health care costs.

 

Prior to initiating this project, we obtained the input of YEA with an FEP and family members. We will also continue to measure engagement across the study. This work fulfills the innovative clinical trial mandate through its implementation and measurement plan, along with the strategy for patient-oriented research through the involvement of patients, family members, and policy makers as equal partners.

Objectives

1. Assess whether implementation of NAVIGATE leads to improvement in fidelity to the EPI standard.
 

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

Hypotheses

1. Assess whether implementation of NAVIGATE leads to improvement in fidelity to the EPI standard.
 

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