Changing the Trajectory: Innovations in First-Episode Psychosis to Reduce Risk of Violence, Suicide, and Legal Involvement-View Presentation

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In this detailed presentation on early psychosis, experts from Columbia University, including a psychiatry resident Deirdre Caffery, Dr. Lisa B. Nossel, Dr. Stephanie Rowland, and Dr. Michael Compton, discussed advancements in addressing risks associated with first episode psychosis. They focused on reducing risks of suicide, violence, and legal issues through innovative, specialized care.<br /><br />The discussion included strategies like OnTrack New York, a program crafting specialized paths for early psychosis intervention. The experts examined various aspects of risks including environmental, psychological, cognitive, and biological influences. They emphasized structured assessment models like the AIM Model for risk management and offered insights into the use of antipsychotic medication such as clozapine for minimizing risks. <br /><br />In exploring violence, Dr. Rowland noted that violent tendencies often decrease over time as individuals engage with treatment. She also discussed the gap between existing violence risk assessment tools and their applicability in early psychosis, emphasizing impulsivity and negative urgency as potential predictors of violence.<br /><br />There was a significant focus on the criminal justice system's role in the lives of individuals with early psychosis, and the sequential intercept model was proposed to better understand interactions at various stages from police contact to parole.<br /><br />The session concluded with audience Q&A tackling challenges like non-coercive engagement strategies and systemic gaps in crisis response for this vulnerable population, underscoring the need for a nuanced and compassionate approach to care.

Keywords

early psychosis

Columbia University

first episode psychosis

OnTrack New York

risk management

AIM Model

antipsychotic medication

clozapine

violence risk

criminal justice system

sequential intercept model

non-coercive engagement

crisis response