Q&A: Creating the first early psychosis intervention clinic in New Orleans

Back in 2015, Ashley Weiss, DO, MPH, an assistant professor of clinical psychiatry at Tulane University School of Medicine, together with Serena Chaudhry, LCSW, MPH, a clinical social worker affiliated with Tulane University School of Medicine’s Department of Psychiatry,  opened New Orleans’ first-ever psychosis-specific clinic in the city, the Early Psychosis Intervention Clinic-New Orleans (EPIC-NOLA). Their goal was to create a sustainable clinic that could provide high-quality first-episode psychosis (FEP) care to a community suffering from high levels of poverty and lack of mental healthcare.

By making connections with other local healthcare organizations and state agencies, EPIC-NOLA has been able to treat hundreds of patients, regardless of their insurance status, with better outcomes than other care models.

PSMJ spoke with Weiss and Chaudhry about creating EPIC-NOLA and the challenges they faced.

This Q&A has been lightly edited for clarity.

Q: What's different about the FEP intervention versus what was being done before?

Weiss: Tragically, throughout history, people experiencing psychosis received [limited] psychiatric services—maybe seeing a psychiatrist once every three months and getting some psychosocial rehab, skill building, those kinds of things. But nothing very intense in the early phases.

[That’s because] people have long thought it was just an absolute that there were going to be negative outcomes for schizophrenia spectrum disorders and that people weren't going to get better. Which is not true.

In Australia, the U.K., and Norway there are several decades of early psychosis intervention research with the goal of full recovery, especially with best practices surrounding combining multiple interventions adapted for young people first experiencing psychosis. For example, psychiatrists finding a common goal with patients on medication management, taking into account that this person may be on medication for the first time and might therefore be more sensitive to side effects. Individual psychotherapy and family supports are critical initially to help someone heal and recover from psychosis, which can often be life changing.

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