The EnTRy Program: Expanding Coordinated Specialty Care Beyond Early Psychosis

Area of Science:

• Psychiatry and Mental Health Services Research
• Clinical Psychology
• Health Services Management

Background:

• Serious mental illnesses (SMI) often require long-term, coordinated care.
• Existing programs may have limitations in diagnosis, age, or treatment duration.
• The Enhanced Treatment and Recovery (EnTRy) Program offers Coordinated Specialty Care (CSC) without these restrictions.

Purpose of the Study:

• To evaluate the quality and clinical benefits of the novel EnTRy Program for individuals with SMI.
• To assess recovery outcomes using Substance Abuse and Mental Health Services Administration (SAMSHA) National Outcome Measures (NOMs).
• To compare treatment engagement of the EnTRy cohort with a historical standard care sample.

Main Methods:

• Compared baseline NOMs with 6- and 12-month follow-up data for EnTRy participants.
• Assessed psychiatric hospitalizations and emergency service encounters within 30 days.
• Used survival analysis (Mantel-Cox logrank) to compare treatment engagement duration between EnTRy and historical cohorts.

Main Results:

• Significant reductions in 30-day psychiatric hospitalizations at 6 months (1% vs. 19%) and 12 months (1% vs. 16%).
• Significant reductions in 30-day psychiatric emergency service encounters at 6 months (1% vs. 18%) and 12 months (2% vs. 16%).
• EnTRy participants showed significantly longer engagement with care (logrank hazard ratio 2.0, p<0.0001) compared to the historical sample.

Conclusions:

• The EnTRy Program demonstrates significant clinical benefits in reducing acute psychiatric care utilization for individuals with SMI.
• Age and diagnosis-unlimited CSC, like EnTRy, may be particularly effective for SMI patients recently discharged from hospital care.
• The EnTRy model shows promise in maintaining treatment gains for individuals transitioning out of early intervention programs.