INNOVATION FUND Innovation, Integration, & Implementation Mental Health and Geriatric Care SHOWCASE 2016 INNOVATION FUND Innovation, Integration, & Implementation Mental Health and Geriatric Care SHOWCASE 2016

Focus on Youth Psychosis Prevention (FYPP) Clinic

Mental Health and Geriatric Care

romina_mazrahi

Romina Mizrahi

romina.mizrahi@camh.ca

416-535-8501 ext.34370
CAMH AFP Governance Organization; CAMH; University of Toronto


Highlights

The Focus on Youth Psychosis Prevention (FYPP) Clinic’s mandate is to implement a new paradigm in the treatment of psychosis: To prevent it before it begins. This empirically well-supported approach has been shown to save individuals from the suffering and impairment of these disorders and to save the health care system costs in the long run. Since the founding of FYPP in 2013, we have processed 241 referrals and identified and treated 55 youth at high risk for psychosis. We have identified early psychosis in an additional 21 individuals and connected them immediately with care, significantly reducing their duration of untreated illness. These factors are both known to improve long-term outcomes in such individuals and we are the only service in Ontario to operate from a prevention model.

Abstract

Through the identification the Clinical High-Risk (CHR) state for psychosis, a set of symptoms that immediately precedes psychosis in up to 35% of cases, our clinic provides early treatment known to mitigate the onset of a psychotic episode. FYPP is a short-term program, ranging from 3-6 months in duration, and takes referrals from primary health care providers, school counsellors, and others. Intervention at FYPP involves routine psychiatric follow-up, psychosocial intervention and/or pharmaceutical intervention. FYPP provides psychosocial group intervention study based on Positive Psychotherapy (PPT), which focuses on stress reduction and the development of resilience. This innovative and highly adoptable approach is already demonstrating a significant reduction in stress  and psychosis-risk symptoms in CHR youth in a pilot study , a finding that has prompted a full clinical trial of PPT in this population. We are heavily invested in basic and translational research, for example applying novel neuroimaging techniques to examine the role of stress and the dopaminergic system in producing psychotic symptoms in CHR youth. Currently, FYPP is also working with international collaborators in a multisite effort known as PSYSCAN to more accurately predict psychosis using neuroimaging, neurocognition, blood-based biomarkers and other cutting-edge techniques.  The resulting prediction tool is planned to be immediately and widely adoptable within Canadian psychiatry, which will allow us to direct resources to those that need it most.. With regard to training, FYPP further provides education for graduate students, psychiatric fellows and postdoctoral fellows.  Such training is central to the dissemination and adoption of the preventative approach more broadly within mental health care.

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