Woodberry Kristen A, Bernier Elizabeth, Elacqua Katherine M, Weiss David M, Ouellette Stacey M, Fanburg Jonathan, Hagler Deborah Q, Herlihy Kathleen A, Hyman Paul L, Jaynes Rebecca B, Yerlig Saras, Mayhew Amy M
Center for Clinical and Translational Science, MaineHealth Institute for Research, Portland (Woodberry, Bernier, Elacqua, Weiss); Department of Psychiatry, Tufts University School of Medicine, Boston (Woodberry); Department of Psychology, State University of New York, Binghamton, Binghamton (Elacqua); Behavioral Health Integration, MaineHealth Behavioral Health, Portland (Ouellette); MaineHealth Pediatrics and Young Adult Medicine, South Portland (Fanburg); MaineHealth Mid Coast Hospital, Brunswick (Hagler); MaineHealth Stephens Hospital, Norway, Maine (Herlihy); MaineHealth Primary Care-Family Medicine, MaineHealth Mid Coast Hospital, Brunswick (Hyman); Child Psychiatry, Maine Medical Center, Portland (Jaynes, Yerlig, Mayhew).
Psychiatr Serv. 2025 Jun 1;76(6):540-546. doi: 10.1176/appi.ps.20240244. Epub 2025 Apr 23.
This study aimed to assess the feasibility of the screening for early emerging mental experiences model, which is designed to screen for psychosis in settings with integrated primary and mental health care.
Psychosis screening, triage, and engagement processes (July 2021-June 2022) were implemented in four integrated care practices serving approximately 7,000 patients in the targeted age range (14-26 years). Practice and community stakeholders participated in the project's design and development. Psychosis care specialists provided training and case consultation to general medical providers and behavioral health clinicians (BHCs). The BHCs screened all patients referred for selective screening. One practice aimed to universally screen patients ages 14-26 attending well visits.
Training sessions were attended by 100% (N=6) of the BHCs and by 79% (N=27 of 34) of the primary care providers. The BHCs selectively screened and triaged 266 patients (89% of their new patients). Providers conducted universal screening of 606 patients (67% of that site's well visits). The screening samples were >90% White and >55% rural, consistent with the clinics' populations. Rates of positive selective screens were consistent with published rates in similar populations. Of the recorded screening-related activities, 92% (146 of 159) were completed within the billable intake time, and 11% (N=17) of these patients were engaged in a psychosis-relevant discussion. The providers reported that the project was important and positive.
Systematic assessment of psychosis symptoms, followed by triage and engagement, appeared to be feasible and acceptable to patients and providers in integrated care settings.
本研究旨在评估早期出现的精神体验模型筛查的可行性，该模型旨在在初级卫生保健与精神卫生保健相结合的环境中筛查精神病。
在为约7000名目标年龄范围（14 - 26岁）患者提供服务的四个综合护理机构中实施了精神病筛查、分诊和干预流程（2021年7月至2022年6月）。机构和社区利益相关者参与了项目的设计与开发。精神病护理专家为普通医疗服务提供者和行为健康临床医生（BHCs）提供培训和病例咨询。BHCs对所有被转介进行选择性筛查的患者进行了筛查。一个机构旨在对14 - 26岁进行健康检查的患者进行普遍筛查。
100%（N = 6）的BHCs和79%（34名中的27名，N = 27）的初级保健提供者参加了培训课程。BHCs对266名患者进行了选择性筛查和分诊（占其新患者的89%）。提供者对606名患者进行了普遍筛查（占该机构健康检查的67%）。筛查样本中白人占比超过90%，农村人口占比超过55%，与诊所的人群情况一致。选择性筛查阳性率与类似人群的已发表率一致。在记录的与筛查相关的活动中，92%（159项中的146项）在可计费的接诊时间内完成，其中11%（N = 17）的患者参与了与精神病相关的讨论。提供者报告称该项目很重要且积极。
在综合护理环境中，对精神病症状进行系统评估，随后进行分诊和干预，对患者和提供者而言似乎是可行且可接受的。
