title: Prevention and recovery in early psychosis (PREP(®)): building a public-academic partnership program in Massachusetts, United States.
abstract: Recently, there has been increasing emphasis on early intervention (EI) for psychotic disorders. EI programs in public mental health settings have been established in countries such as Australia, the United Kingdom, and Canada. However, there are relatively few EI programs in the United States (U.S.). Here we describe the conceptual origins and practical development of the PREP program, i.e., Prevention and Recovery in Early Psychosis, as it evolved in a public academic psychiatry setting in Boston, Massachusetts, U.S. PREP developed over a decade through a partnership between the Massachusetts Department of Mental Health and academic institutions within the Harvard Department of Psychiatry. We discuss the evolution, programmatic features, funding mechanisms, staffing, and the role of clinical training in PREP. The key principles in developing the PREP Program include the focus on early, evidence based, person-centered and phase-specific, integrated and continuous, comprehensive care. This program has served as a foundation for the emergence of related services at our institution, including a research clinic treating those at clinical high risk or within the putative "prodromal" period preceding frank psychosis. This account offers one possible blueprint for the development of EI programs despite the lack in the U.S. of a national mandate for EI or prevention-based mental health programs.
authors: Private Practice, Boston, MA, USA.
authors: Brina
authors: B
authors: Caplan
authors: Suzanna V
authors: SV
authors: Zimmet
authors: Eric C
authors: EC
authors: Meyer
authors: Michelle
authors: M
authors: Friedman-Yakoobian
authors: Thomas
authors: T
authors: Monteleone
authors: Y
authors: Y
authors: Jude Leung
authors: Margaret E
authors: ME
authors: Guyer
authors: Laura Logue
authors: LL
authors: Rood
authors: Matcheri S
authors: MS
authors: Keshavan
authors: Larry J
authors: LJ
authors: Seidman
mesh_terms: D000293:Adolescent; D000328:Adult; D001900:Boston; D003299:Cooperative Behavior; D042241:Early Diagnosis; D061345:Early Medical Intervention / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care / Q000379:methods; D016730:Program Development / Q000379:methods*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000628:therapy*; D012040:Regional Health Planning / Q000379:methods*; D055815:Young Adult