Utilization of a psychosis consultation service: Early lessons from a statewide initiative

Abstract

In February 2024, the Program for Specialized Treatment Early in Psychosis (STEP) in Connecticut launched the STEP Learning Collaborative (STEP-LC), a statewide learning health system. As part of this initiative, STEP-LC introduced a free consultation service to support clinicians, administrators, and healthcare leaders in the continuing care of young people with recent-onset psychosis (ages 16–35). As the only coordinated specialty care (CSC) clinic in the state offering this provider-to-provider service, STEP aims to address clinical and systemic challenges by providing expert guidance on medication management, psychotherapy, family engagement, and program development. Consultations are requested through a brief online form publicly available on the STEP-LC website. Experts at STEP aim to respond within one business day to initiate discussions regarding the identified case. The service is designed to be flexible, offering one-on-one meetings, integrating consultations into existing team meetings at the requesters' agencies, and allowing outside organizations to observe STEP operations. To date, 26 consultations have been completed: 24 within the state and 2 from out-of-state. Within-state requests primarily involved direct clinical issues, such as treatment planning, transitions of care, and family support strategies. Out-of-state consultations focused on broader systemic needs, including the development of new early psychosis programs and collaborative networks. Feedback from consultees highlights the value of the service in enhancing the quality and accessibility of psychosis care. This initiative underscores the importance of leveraging specialized expertise to support both individual and systemic efforts in early psychosis intervention.