Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Early Assessment and Support Alliance (EASA)

Name of Innovative Program: 
Early Assessment and Support Alliance (EASA) for Early Psychosis Care
Sponsoring Organization
Early Assessment and Support Alliance (EASA)
Name of Innovative Program Lead: 
Irene Hurford
E-mail Address of Innovative Program Lead: 
ihurford@upenn.edu
Project Description: 
 Psychotic disorders affect three in 100 individuals.  Until recently, psychosis was considered a life sentence to disability, often leading to legal issues, involuntary hospitalizations and fear of mental health providers, trauma, high rates of suicide and accidental death, and long-term poverty and disability.  In 2001, a behavioral care network in Salem Oregon developed an early intervention model for psychosis. The model was tremendously successful and led to funding through the Oregon legislature to expand the program statewide.  EASA (Early Assessment and Support Alliance) was born. Since then, hundreds of young people experiencing psychosis have had a fundamentally different treatment experience than what existed prior to EASA.  Individuals who are part of EASA have had major reductions in hospitalizations and most have successfully continued with school and work. EASA participants demonstrate that with the right support individuals with psychosis can complete school, work, and live successfully as active community members.
Creativity and Innovation: 
 EASA was the first systemic effort to integrate early psychosis intervention into a community mental health system in the United States. Twelve years later, it remains one of the only early episode programs that are centered in a community mental health setting, as opposed to an academic center. From it’s earliest beginnings EASA borrowed and adapted programs and treatments from all over the world and integrated them into one of the first truly comprehensive early episode programs in the country. The framework for their program came from the seminal early episode work done in Melbourne, Australia and their practice guidelines for working with early psychosis. EASA then added models of Psychoeducation, supported employment, treatment for dually diagnosed psychosis and substance abuse participants, family-centered treatments, and others. This amalgam of programs and treatments was truly innovative and creative at the time, and has been replicated by other centers over the years. 
Leadership: 
 EASA began with local department of mental health and private foundation funding. In six years their results were so impressive that the Oregon legislature committed over four million dollars to sustain and expand EASA. In response to the need to disseminate the model, EASA developed the Technical Assistance Center which serves to write the practice guidelines and fidelity tools, develop, provide, and facilitate training, supervision, and credentialing, develop written materials, media outreach, articles and publications, facilitate program development and access sustainable funding, and evaluate and coordinate research activities, data collection, reporting and analysis. EASA has become a leader in the dissemination of early psychosis models of care across Oregon, and they are also providing training and supervision in centers in California and Washington. In Philadelphia, we are hoping to partner with EASA to bring their leadership in early psychosis care to our city as we establish an early psychosis program. 
Sustainability: 
 A network of local, statewide, and private sources fund the EASA program. Funding includes the Oregon legislature, which has provided over eight million dollars since 2007 to sustain and expand EASA, and local managed healthcare and mental health centers in all parts of Oregon who have committed to moving forward with statewide implementation of EASA. Private foundations, particularly The Robert Wood Johnson Foundation, Meyer Memorial Trust, Spirit Mountain Community Fund, Northwest Health Foundation and The Paul G. Allen Charitable Foundation, have all provided resources. Foundation support was also instrumental in helping to leverage the ongoing realignment and allocation of state funds. Legislators and private foundations alike are persuaded by stories of young people with psychosis who can now describe a frightening but temporary disruption to their lives, as opposed to a descent into chaos and poverty, and mental health and justice systems resorting to involuntary and ineffective care.
Replicability: 
 Twelve years after its inception in five counties in Oregon, EASA has established a process for program establishment, training, supervision, and program development that has been successfully implemented in an additional thirteen counties. There is legislative and local support to move forward with statewide implementation of EASA. The goal behind applying for the Scattergood Innovation award is to use the funds to bring the EASA model to Philadelphia. We are developing an early psychosis program in Philadelphia called Psychosis Education, Assessment, Care, and Empowerment (PEACE). PEACE plans to implement the EASA model with high fidelity in an effort to replicate the same impressive outcomes as EASA.  The award funds will be used to bring trainers and reviewers to Philadelphia, and to pay for materials for training, participant and family psychoeducation, and program advertising. 
Results/Outcomes: 
 From 2008 through 2011, more than 1600 families were referred to EASA programs across the state, and almost 600 received services.  EASA currently serves about 400 individuals and families per year. Of those enrolled, hospitalization rates dropped from over 50% in the three months prior to enrollment to less than 10% after 22 months in the program. After twelve months in EASA, 30% of participants were working, versus 11% at intake, and 34% of participants remained in school. 74% of participants demonstrate either symptom remission or only mild symptoms after 12 months in the program, and 95% maintain strong family support and involvement.  These metrics of symptom assessment, functional and occupational outcomes, hospitalization data, and family data, are only some of the measures collected. Other measures can be found on EASA’s website under Resources for Professionals, Quarterly Outcome Review, or at http://www.eastcommunity.org/shop/images/outcome_review_version_6.pdf.  
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