Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

Strong 365

Name of Innovative Program: 
Shortening the Pathway to Care For Psychosis Through Digital Outreach
Sponsoring Organization
Strong 365
Name of Innovative Program Lead: 
Chantel Garrett
E-mail Address of Innovative Program Lead:
Physical Address of Innovative Program: 
2323 Broadway, Oakland, CA 94612
Project Description: 

Despite the proven power of early intervention to change lives, most of the 100,000 young Americans who face first episode psychosis each year miss this window of opportunity. Strong 365 is changing that through a first-of-its-kind digital youth outreach program that shortens the pathway to effective care.

The Project employs search engine and social media marketing strategies to identify young people experiencing early symptoms of psychosis and connects them with treatment, information and resources to accelerate help-seeking and recovery. In partnership with early psychosis treatment centers, the Project crafts local, mobile-focused digital campaigns to drive young people to seek help in their communities before crisis emerges. 

Content and strategy is guided by the organization's Youth Leadership Board - a group of 16-29 year olds with personal experiences of psychosis recovery - and led by a former marketing executive of a Fortune 200 company.

How does the innovative program work to improve behavioral health access?: 

The delay from onset of symptoms to accessing care is directly correlated with negative health and quality of life outcomes, even decades later. However, today the average delay in seeking treatment for psychosis is more than one year.

According to recent research, lack of knowledge about brain health, how to describe early symptoms, shame and stigma are the chief obstacles to seeking help for psychosis. Strong 365 is breaking down these barriers with accessible, educational and personal narrative content that demystifies and humanizes the experience of psychosis.

While a spectrum of resources are offered, the Project directs its target audience to early treatment programs - an empirically validated model of care focused on accelerating recovery. Outcomes from Connecticut’s STEP program serve as a recent example: participants experienced double the rate of full-time employment and 10 times better symptom reduction than treatment-as-usual.

How does the innovative program work to improve behavioral health quality? : 

Strong 365 accelerates access to quality care by equipping young people with the knowledge, language and resources to seek effective help at the right time. A recent large-scale trial of early treatment for psychosis (RA1SE) concluded that significant quality of life gains made by early treatment program participants was a result of "doing the right things at the right time."

The “right things” means emphasis on fostering well-being in the domains of health, relationships and purpose (school, work, hobbies) through a person-centered approach to treatment that empowers a participant to build skills and resilience.

Despite a wave of new treatment program development driven by increased federal funding directed at early psychosis intervention, public awareness about the promise of early intervention remains exceedingly limited. Strong 365 is closing this awareness gap by identifying impacted individuals families and connecting the right time.

How does the innovative program work to address behavioral health costs? : 

In addition to employing a highly cost-efficient medium - digital media - Strong 365 will have a measurable impact on reducing the costly downstream effects of untreated psychosis: routine hospitalization, disability, un/under-employment, disenfranchisement, incarceration, suicide and early death.

Schizophrenia alone costs the United States $62 billion each year, with more than half attributed to the impact of lost wages, productivity and premature death. Thus, there is considerable opportunity to cut indirect costs by reducing disability associated with psychosis through early detection and treatment.

There is also ample opportunity to save health care dollars spent on ineffective status-quo treatment - namely, routine hospitalizations. In 2014, London School of Economics found that early psychosis treatment in the UK saved $15 for every $1 invested over 10 years. The US “RA1SE” study echoed this finding, concluding that early treatment is cost effective.

Creativity and Innovation: 

Strong 365 is the first campaign to bring psychosis outreach fully into the digital age, modeled after commercial brand marketing strategies. With mobile, social, text and video messages authentically crafted by young people with lived experience, the Project is intended to reach young people where they are - on their smartphones:

●      Teens check their social media accounts as much as 100 times per day

●      92% go online daily; 91% access via a mobile device

●      84% search for health information online

The use of digital media offers a highly scalable, measurable, replicable and cost-efficient means of outreach as compared to grassroots or traditional media. A data-informed approach, the Project leverages powerful analytic platforms to track user engagement across a variety of metrics, and optimize and package insights for a variety of public health applications.


Strong 365 is partnering with clinical programs to implement geographically and culturally tailored digital outreach strategies to drive local awareness.

Teens spend an average of nine hours a day on digital media, according to a 2015 report by CommonSense Media. In stark contrast to this reality, clinical programs do not generally house marketing or digital communication expertise, leaving young people in the dark about how and where to seek help for psychosis in their communities.

Starting with early treatment partners in California and New York, Strong 365 seeks to build capacity to serve to 25+ early treatment programs per year, and empower many more to employ their own digital strategies by sharing Strong 365 insights. (There are currently ~120 early psychosis programs in the US, with many more in development.) 


Currently in pilot phase, Strong 365 is collaborating with two primary academic partners, Dr. Michael Birnbaum, director of the Early Treatment Program at Northwell Health/Zucker Hillside Hospital, and Dr. Rachel Loewy, director of clinical high risk and first episode psychosis programs at UCSF, to evaluate and understand digital help-seeking behavior for early stage psychosis.

The Strong 365 team is supported by an 11-member National Youth Advisory Board who drive content and outreach strategy, as well as an Advisory Board of industry-leading experts in early psychosis/mental health treatment, research and policy.

Current partner organizations include: One Mind Institute (IMHRO), Mental Health America, Child Mind Institute, Felton Institute and The McKenzie Foundation


Using readily scalable and replicable outreach strategies and content, Strong 365 is partnering with early treatment systems of care that seek to add a digital component to their community outreach efforts (this could be as targeted as one county or as broad as a state or region).

The Strong 365 team serves as a creative consultancy - creating a campaign landing page, digital ads and content linking young people to their local early treatment program; optimizing the campaign over its lifecycle and measuring impact. 

Beyond campaigns run in partnership with early treatment programs, Strong 365's mapping of the digital help-seeking journey through robust data collection will enable distribution of insights to mental health care systems in the form of case studies, academic papers, its blog and consultation services, creating the potential for a wide range of potential activation by mental health providers. 


The Project will analyze data in the following areas to understand digital help-seeking behavior for early stage psychosis:

●      Demographics (age, gender, location, primary language) and interests

●      Message and channel efficacy (ex. keywords, social channels, devices used)

●      User behavior patterns: understanding the pathway and barriers to help

●      Referrals into EIP programs and health/quality of life outcomes following participation

Ultimately, our evaluation will answer:

●      What effect can digital marketing have on shortening the pathway to care? What are the primary barriers?

●      What tools and messages are most effective?  With what audience?

  • What are the most effective and efficient means of using these tools to drive early treatment program referrals and participation?