Investor Presentaiton

NEVADA Early Treatment Program for First Episode of Psychosis (FEP) Based on: The RAISE (Recovery After an Initial Schizophrenia Episode) Research Initiative, National Institute of Mental Health (NIMH) and the NAVIGATE Early Treatment Program for First Episode Psychosis Presenter: Ruth Condray, Ph.D., Program Lead, Nevada Early Serious Mental Illness/First Episode of Psychosis (ESMI/FEP) Program Background and Significance: Nevada Department of Health and Human Services recognizes the importance of building a statewide evidence- based program of early interventions to address early-stage psychotic disorders. Setting this priority follows recognition of key factors by national and international mental health communities and funding agencies: ✦ Historically, mental health services have focused on the later stages of serious mental illness (SMI), which has meant that interventions often occur only after things have reached a crisis and only after prolonged periods of untreated illness. ◆ Duration of Untreated Psychosis (DUP): The length of time that a person does not receive treatment for psychosis predicts the severity of his or her clinical outcome. Definition of DUP: Length of time between the onset of a psychotic disorder and the point when an individual enters treatment. ✦ Funding priority & guidance by SAMHSA have also been informed by: Advocacy efforts by clients and their family members urging Mental Health Systems to do more when people first experience ESMI/FEP. Societal & Economic Burden of Schizophrenia Psychosis, alone, was $155.7 billion in US in 2013, which included additional costs associated with unemployment, productivity loss because of caregiving, and direct health care. ✦ Goals of Program: Early interventions for early-stage psychosis may accomplish the following: Prevent or delay medical and psychological impairments, suicides and undesirable social circumstances (poverty and homelessness). Reduce the numbers of periods with severe symptoms. Improve social functioning and clinical outcomes. SAMHSA MH Block Grant funding, FFY 2020-2021: Minimum 10% set aside. Target Population: How many new cases of FEP occur each year? The median rate of new cases (incidence) each year for schizophrenia, one of the principal schizophrenia spectrum and other psychotic disorders, is estimated to be 15.2 per 100,000 population. First episodes show a peak onset between ages 15-25 years, although approximately 20% have an onset after age 40. Based on these estimates, the expected annual rate of new cases of schizophrenia in NV is approximately 300. Priorities: Statewide implementation of NAVIGATE, an evidence-based early treatment program of Coordinated Specialty Care (CSC) for individuals experiencing a first episode of psychosis, including: ✦ Northern Nevada Behavioral Health Region: Clinic Home, Carson Tahoe BH Services, Carson City, which began enrolling clients in FEB 2019. + Clark Behavioral Health Region: Clinic Home, UNLV/Mojave Counseling, Las Vegas, which began enrolling clients in FEB 2020. + Washoe Behavioral Health Region: Clinic Home, UNR SOAR Program, Reno, which was launched in August, 2021. Coordinated Specialty Care (CSC) is provided by a multi-disciplinary team of mental health professionals whose clinical expertise span biological, psychological and social work domains. Recovery-oriented interventions involve clients, multi- disciplinary team members and family members. CSC feasibility and efficacy have been demonstrated for community mental health settings, as well as for rural and low-density population regions. The evidence-based NAVIGATE program for FEP involves a manualized protocol of four core interventions (https://raiseept.org/): Pharmacotherapy & Primary (Medical) Care Coordination (RX & PCC); Individual Psychotherapy-Individual Resiliency Training (IRT); Family Education (Family ED; Supported Employment & Education (SEE). Assertive Case Management and Peer Support Services are also provided. NAVIGATE Program of Coordinated Specialty Care (CSC) for FEP PEER Support CASE Mgt RX & PCC IRT Client Relatives TX Team FAMILY ED SEE

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