# Reducing Duration of Untreated Psychosis through Early Detection in a Large Jail System

> **NIH NIH R34** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2020 · $307,454

## Abstract

Longer duration of untreated psychosis (DUP) is linked to poorer outcomes in first-episode psychosis
(FEP). Coordinated Specialty Care (CSC), exemplified by New York State’s OnTrackNY programs, improves
outcomes through early, multi-component care; however, DUP remains unacceptably long. There is evidence
that young adults with FEP who are involved in the criminal justice (CJ) system (where there is likely a much
greater prevalence of undetected, untreated psychosis than in the general population) have an alarmingly long
DUP. Thus, although primary care settings (e.g., clinics) and educational institutions (e.g., colleges) may be
important sites for early detection, there is a need to establish early detection services within the CJ system
(and in particular, urban jails) and to create pathways from CJ involvement to CSC enrollment.
 Relying on prior research, relevant theory, and our findings on DUP, pathways to care, CSC, and the CJ
system, we propose 4 intervention development aims. First, we will implement a “Public Information Campaign”
(PIC) in 2 jails at New York City’s Rikers Island, which will detect FEP earlier, reduce our DUP-1 (psychosis
onset to medication initiation) and lead to referrals of detainees to the Early Detection Team (EDT). The PIC
will accomplish this via three measurable targets/mediators (cumulative number of print materials disseminated
in the jail, cumulative number of Corrections Officers and Correctional Health Services staff trained in early
psychosis and how to refer to EDT, and change in scores on 3 Social Cognitive Theory constructs [Study 1]).
Second, we will implement an EDT in the same 2 jails, which will increase the likelihood of referred detainees
found to have FEP engaging with CSC (e.g., an OnTrackNY program in the detainee’s borough of residence)
upon release, and reduce our DUP-2 (psychosis onset to CSC enrollment). The EDT will accomplish these
goals via a key target/mediator (minutes of face-to-face contact with the detainee while in jail and telephone
contact following release). Clinical interviews with detainees referred to the EDT will comprise Study 2. Third,
we will thoroughly study acceptability and feasibility of the jail-based PIC and EDT, which will give us
information needed in advance of a larger, multi-site, definitive effectiveness trial. Regarding acceptability, we
will conduct stakeholder interviews and focus groups with all relevant end-users of the new intervention
(PIC+EDT) [Study 3]. In terms of feasibility for a larger trial, data on a number of metrics will be collected.
Fourth, we will prepare an Intervention Manual for broader use in diverse jails and further formal research.
 In summary, city and county jails likely have a relatively high number of young people with undetected and
untreated FEP, stemming from the criminalization of mental illnesses, fragmentation between CJ and mental
health sectors, and a lack of early detection initiatives in such settings to date. Once th...

## Key facts

- **NIH application ID:** 9976613
- **Project number:** 5R34MH117766-02
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** MICHAEL T COMPTON
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $307,454
- **Award type:** 5
- **Project period:** 2019-07-15 → 2022-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976613

## Citation

> US National Institutes of Health, RePORTER application 9976613, Reducing Duration of Untreated Psychosis through Early Detection in a Large Jail System (5R34MH117766-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9976613. Licensed CC0.

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