Pathways to Possibility: An Equitable and Accessible Referral System for Early Psychosis Intervention

Rebecca Wlcek BA (1), James Green BA (1), Henry White MD (1), Kelsey Johnson MPH (2), Iqra Imam MPH (2), Emily Gagen PhD (1,3)

1. Massachusetts Psychosis Access and Triage Hub (M-PATH), of the Brookline Center for Community Mental Health, Brookline MA
2. Massachusetts Psychosis Network for Early Treatment (MAPNET) Boston, MA
3. Harvard Medical School, Cambridge, MA

Background: Recent estimates suggest 1,136 first episodes of psychosis (FEP) per year. Longer duration of untreated psychosis (DUP) is associated with negative outcomes. Coordinated specialty care (CSC) programs have demonstrated efficacy in improving outcomes for FEP. To equitably serve our diverse population and increase access to care in the state, the Massachusetts Psychosis Access and Triage Hub (M-PATH) was created to improve access to specialized FEP services.
Method: M-PATH is a statewide service that offers support to clients, family members, and providers. Stakeholders can contact M-PATH to receive an initial screening for psychosis, consultation, and/or referrals to community resources and CSC. Check-ins with clients and family members throughout the referral process ensure continuity of support. Providers are offered ongoing consultation to support the development of a community workforce delivering "psychosis-informed care". Demographic information is collected at baseline, while outcomes and needs are collected at 1-month. Demographic and program performance data were analyzed using descriptive statistics. Data is presented between 1/1/2023 - 6/30/2023 to demonstrate feasibility in improving access to FEP care.
Results: 30 clients and families and 35 providers contacted M-PATH. Client’s self-referring had an average age of 28.5 (17.99), families 23.94 (9.5), and providers 18.96 (7.57). 70.6% of referrals were white, 17.6% Black or African American, and 5.9% Asian. 31.7% were female, 60% male, 5% transgender, and 3.3% non-binary. On average for FEP clients, time between the 1st contact with M-PATH and an appointment at a CSC clinic was 35.42 days. 44.6% of service recipients were referred to FEP programs, 10.8% referred to CHR-p clinics, 12.3% of providers were supported to continue care.
Discussion: M-PATH's model demonstrates promising speeds of access to care for clients (~35.42 days vs. 140 days). In addition, M-PATH’s model of care demonstrates potential to improve equitable access, reduce DUP, and identify barriers for care.