Groundbreaking Program for Preventing Early Psychosis

 One of 81 HHS Health Care Innovations Awards

Monterey – Family Service Agency of San Francisco’s (SFFSA) Prevention & Recovery in Early Psychosis (PREP) Program has been awarded a highly competitive $4.7 million Health Care Innovation Award by the US Centers for Medicare & Medicaid Services. This funding will allow FSA to expand the PREP program to Monterey and San Joaquin counties to include evaluation of PREP as a potential national model for treatment of schizophrenia.  Services in Monterey County will begin in December 2012. This new collaboration with SF Family Services Agency represents an important expansion of mental health services in Monterey County.

      PREP was selected for funding because it shows great promise in providing much better results at lower cost in serving teens and young adults with schizophrenia or at high risk of developing schizophrenia.  PREP was one of only 108 grantees selected from over 3,000 proposals received in the competition. 

      PREP was developed in 2007 as a partnership between FSA and a team of researchers from the University of California, San Francisco. Piloted first in San Francisco, preliminary results have been so positive that Alameda and San Mateo counties used Mental Health Services Act funding to bring PREP to their communities. Initial results in San Francisco show a 50% reduction in hospitalizations among participants in the PREP program along with a significant improvement in engagement in work and school, as well as enhanced client capacity to manage symptoms.

“Monterey is pleased to be a collaborative partner in this national award. PREP has the potential to change the life trajectory of individuals who have or are at risk for schizophrenia.  We are honored to be able to be a part of this national health reform effort,” commented Wayne Clark, Chief Behavioral Health Bureau, Monterey County Health Department.

      Schizophrenia is a major mental illness that typically emerges in individuals ages 14-25.  Typically lasting a lifetime, it is one of the nation’s most debilitating and expensive chronic health conditions.  PREP was designed to prevent the onset of schizophrenia among high risk individuals and to enable individuals who develop schizophrenia to recover. “We are still learning how and why PREP is so effective in helping individuals with early psychosis to function so well. This award will enable us to expand that understanding and contribute to the continuing national effort of early intervention in psychosis and schizophrenia,” noted Dr. Rachel Loewy, a UCSF researcher central to PREP’s development.

      Treatment-as-usual for schizophrenia relies heavily on antipsychotic medications—which often come with very severe side effects—combined with minimal psychotherapy.  This approach to treatment leads to high rates of treatment refusal which leads in turn to frequent, expensive hospitalizations and increasing disability.  In contrast, the core treatments combined in the PREP program are rigorous early diagnosis and treatment; commitment to judicious medication regimens, utilizing only one antipsychotic medication wherever possible, at the lowest effective dose; training for youth and families in how to recognize, minimize, and manage symptoms; and computer-based cognitive training to rehabilitate areas of the brain damaged by the disease.

      Health and Human Services (HHS) Secretary Kathleen Sebelius announced the recipients of 81 new Centers for Medicare & Medicaid Services (CMS) Health Care Innovation Awards made possible by the health care law, the Affordable Care Act. The awards will support innovative projects nationwide designed to deliver high-quality medical care, enhance the health care workforce, and save money. Applicants projected that these programs would save the health care system an estimated $1.9 billion over the next three years.  Awardees were chosen for their innovative solutions to the health care challenges facing their communities.  “Thanks to the health care law, we are giving people in local communities the resources they need to make our health care system stronger,” said Secretary Sebelius. 

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