Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) in California - Behavioral Health Center of Excellence
Our goal is to help California behavioral health delivery systems and behavioral health practitioners deliver the most effective care possible. We do this by training and supporting the implementation of Coordinated Specialty Care (CSC), a proven method for improving access, engagement, and outcomes among individuals with lived experience of early psychosis.
EPI-CAL is proud to serve as a Center of Excellence (COE) for the implementation of the Coordinated Specialty Care for First Episode Psychosis Evidence-Based Practice (EBP) as part of California’s effort to expand access to and strengthen the continuum of community-based behavioral health services for individuals living with significant behavioral health needs. Go to the Behavioral Health COE Resource Hub for information about participating COEs and EBPs.
Transform early psychosis care in California.
Partner with EPI-CAL to implement Coordinated Specialty Care (CSC) and improve access, equity, and outcomes for individuals and support systems across California.
About Early Psychosis Intervention California (EPI-CAL)
EPI-CAL, developed by UC Davis, UC San Francisco, UC San Diego, and Stanford University, provides training, technical assistance, and outcome data collection to support the implementation and sustainability of EP programs across California. Our goals are to support the provision of high-quality EP care to all Californians and to promote recovery.
CSC is a community-based service designed for members experiencing first episode psychosis (FEP). By providing timely and integrated support during the critical initial stages of psychosis, CSC reduces the likelihood of psychiatric hospitalization, emergency room visits, residential treatment placements, involvement with the criminal justice system, substance use, and homelessness.
CSC is a comprehensive, team-based service in which multidisciplinary teams provide a wide range of individualized supports to members exhibiting initial signs of psychosis.
Programs and Services
The implementation of CSC services in California has been more diverse than in other regions of the US. California has historically adopted a very county-driven, bottom-up approach to behavioral health care delivery. The advantage is that this allows counties a lot of flexibility to deliver services in a way that addresses the needs of the community and allows them to leverage available community resources. However, it has also meant that delivery of CSC and other behavioral health services are highly variable county by county.
Many CSC programs serve First Episode Psychosis (FEP), which refers to the individuals who have experienced the onset of threshold psychosis within the past five years. California programs also tend to include both non-affective and affective psychosis in this group. Ages served can vary from as young as age 12 up to age 65. Clinical High Risk (CHR) refers to individuals showing clinical signs that they may be at higher risk for the development of psychosis. While we encourage EP programs to identify and serve CHR individuals, it should be noted that the primary function is to assist programs that target and treat FEP, according to the terms of our grants.
Specialized EP care, which comprises of a coordinated multidisciplinary team providing services such as assertive case management, specialized clinical assessment, outreach, pharmacotherapy, psychotherapy, supported education and employment services, family education and support, and peer services has consistently been found to improve outcomes (Criag et al., 2004; Thorup et al.,2005; Kane et al., 2016).
As mentioned above, many California programs have incorporated Peer Support Specialists and Family Partners at all levels of the program (e.g. from decision making to service delivery). More core components of the model are assessed by the First Episode Psychosis Services Fidelity Scale (FEPS-FS) (Addington et al., 2018), which is the tool EPI-CAL will use to measure adherence to the CSC model. EPI-CAL will assist EP program staff in reaching higher levels of fidelity to the CSC model.
Training
Learning Management System - Cornerstone
Cornerstone Learning Path UPDATE: We are pleased to announce that we have updated all learning paths in the Cornerstone system! The existing learning paths have been updated to include new Foundational trainings to standardize topics across roles and reduce the pathways to be no longer than 30 hours total. These adjustments will require everyone to complete the new trainings, just as we have done historically when adding new required trainings. The new trainings should take no longer than 6 hours to complete. We believe these adjustments will comprehensively support staff and are more reflective of current best practices. We will also be launching new evaluations as part of these changes to hopefully more accurately receive feedback on the modules. Please reach out if you have any questions!
Cornerstone User Guide UPDATE: We are pleased to announce that we have updated the Cornerstone User Guide to reflect the new changes in the learning paths, as well as additional updates that were needed. In order to access the new User Guide, please click the link below.
WE’D LOVE YOUR FEEDBACK! We would love to hear any feedback you have that will help us improve Cornerstone. You can take our 5-minute Cornerstone feedback survey. Please click the link below to access the survey.
EPI-CAL is California’s Center of Excellence for CSC for FEP, supporting behavioral health systems and practitioners in delivering evidence-based, equitable care for individuals experiencing early psychosis.
Our work spans multiple sites across the state, including UC Davis, UC San Diego, UC San Francisco and Stanford University providing training, technical assistance, and implementation support local communities within California.
County behavioral health agencies: Interested in initiating a consultation with us? Complete an Engagement Initiation Form. If you are a behavioral health practitioner, please coordinate with your county behavioral health plan (BHP).
