RESIDENT: Early Psychosis Intervention Programs: Clinical Impacts, Economic Value, and the Need for Urgent Provincial Expansion in Alberta

Learning Objectives

1. Review of clinical evidence for EPIP programming;

2. Exploration of Canadian and International economic evaluations of EPIP programming;

3. Summation of present EPIP programming in Alberta; and

4. Call to action regarding strengthening and expanding EPIP programming in Alberta. 

Abstract

Early Psychosis Intervention Programs (EPIPs) are among the most compelling and evidence-based innovations in psychiatric care. Extensive research demonstrates that timely, phase-specific intervention significantly improves positive and negative symptom severity, global and social functioning, rates of treatment discontinuation, relapse, and hospitalization, as well as rates of remission and recovery, while also enhancing engagement in education and employment [1-6]. Long-term follow-up studies further confirm sustained benefits in symptom remission, functional recovery, and reduced hospital utilization, with effectiveness consistently maintained in real-world settings [4]. 

Furthermore, EPIPs are highly cost-effective and deliver substantial healthcare savings and improved patient outcomes compared to standard care, with Canadian data providing particularly strong support [7- 11]. A national economic evaluation using Canadian administrative data and real-world costs from 52 EPI centers found that early psychosis intervention yielded a net benefit of $85,441 (2019 CAD) per patient over five years versus treatment as usual [10-11]. International systematic reviews further corroborate that EPI services are consistently cost-effective compared to standard care [7,9]. 

Despite this robust evidence base, Alberta's availability and distribution of EPIPs remains insufficient to meet population needs; our limited program capacities create inequitable access to timely assessment and specialized treatment [12-14]. As incidence rates of psychotic disorders remain stable and population growth continues, Alberta faces an urgent need to expand and strengthen EPIPs. 

In summary, this presentation reviews the clinical and economic literature surrounding EPIPs and outlines the case for a coordinated, provincially scaled expansion of EPIPs in Alberta to improve access and outcomes. 

Literature References

1. Correll CU, Galling B, Pawar A, et al. Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-Analysis, and Meta-Regression. JAMA Psychiatry. 2018;75(6):555-565. doi:10.1001/jamapsychiatry. 2018.0623. 
2. Solmi M, Croatto G, Piva G, et al. Efficacy and Acceptability of Psychosocial Interventions in Schizophrenia: Systematic Overview and Quality Appraisal of the Meta-Analytic Evidence. Molecular Psychiatry. 2023;28(1):354-368. doi:10.1038/s41380-022-01727-z. 
3. Williams R, Ostinelli EG, Agorinya J, et al. Comparing Interventions for Early Psychosis: A Systematic Review and Component Network Meta-Analysis. EClinical Medicine. 2024;70:102537. doi:10.1016/j.eclinm.2024.102537. 
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8. Correll CU, Galling B, Pawar A, et al. Comparison of Early Intervention Services vs Treatment as Usual for Early-Phase Psychosis: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Psychiatry. 2018;75(6):555-565. doi:10.1001/jamapsychiatry.2018.0623. 
9. Shields GE, Buck D, Varese F, et al. A Review of Economic Evaluations of Health Care for People at Risk of Psychosis and for First-Episode Psychosis. BMC Psychiatry. 2022;22(1):126. doi:10.1186/s12888-022- 03769-7. 
10. Tarride JE, Blackhouse G, Abdel-Baki A, et al. Economic Evaluation of Early Psychosis Interventions From a Canadian Perspective. Canadian Journal of Psychiatry. 2022;67(10):768-777. doi:10.1177/07067437221087044. 
11. Groff M, Latimer E, Joober R, et al. Economic Evaluation of Extended Early Intervention Service vs Regular Care Following 2 Years of Early Intervention: Secondary Analysis of a Randomized Controlled Trial. Schizophrenia Bulletin. 2021;47(2):465-473. doi:10.1093/schbul/sbaa130. 
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