Understanding the implementation of coordinated specialty Care for Early Psychosis in New York state: A guide using the RE-AIM framework

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Amplify OnTrackNY publication summaries summarize peer-reviewed publications focused on quality improvement or research conducted to help us learn & improve the program.

Study snapshot

This study uses the RE-AIM framework to evaluate the effectiveness and delivery of the OnTrackNY program.¹  What is the RE-AIM framework?

• Reach: Of all those needing help, how many are actually enrolled in OnTrackNY?
• Effectiveness: How is participants’ recovery affected by services?
• Adoption: Do clinicians want to provide OnTrackNY services across NY state?
• Implementation: Do teams follow OnTrackNY guidelines?
• Maintenance: Are there plans addressing long-term funding for OnTrackNY?

Study findings

Teams report on participant substance use, symptoms, and hospitalizations at enrollment and every three months after. For this study, authors looked at information collected between October 2013 and December 2019.

Finding 1. From 2013 to 2018, 1215 individuals enrolled. Given estimates of at least 3960 individuals needing treatment in NY state, the reach of OnTrackNY needs to expand.

Finding 2. In terms of effectiveness, studies show that in the first year at OnTrackNY, education and employment rates increase from 40% to 80%, hospitalization rates decrease from 70% to 10%, and ability to maintain relationships and perform work and school tasks, and symptoms improved.

Finding 3. Challenges finding sites in rural and suburban areas, and a lack of available qualified staff, has made adoption of the OnTrackNY program difficult in some regions of NY state.

Finding 4.With regards to implementation, OnTrackNY team members report feeling comfortable with the practices and approach covered in training. Early data shows that programs have performed well following guidelines.

Finding 5 .The OnTrackNY program is maintained and subsidized by state and federal dollars.

Figure 1: How effective is OnTrackNY?

In a study of 325 OnTrackNY participants, education and employment rates increased, hospitalization rates decreased, and the ability to maintain relationships and perform work and school tasks, and symptoms improved.

Final thoughts

OnTrackNY is an innovative model that can be further implemented nationwide in order to provide services to persons experiencing first episode psychosis. However, more work needs to be done to prove OnTrackNY’s reach and address concerns about its financial sustainability.

References

1. Humensky JL, Nossel I, Bello I, Dixon LB. Supported Education and Employment Services for Young People with Early Psychosis in OnTrackNY. J Ment Health Policy Econ. 2019 Sep 1;22(3):95-108. PMID: 31811753; PMCID: PMC6902640.

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