First Episode Mood and Anxiety Program (FEMAP)

Issues 

This program was designed to fill the gap in psychiatric services that exists for addressing the early stages of mood and anxiety disorders (with or without addictions) in emerging adults -- the most common mental illnesses during the most frequent age of their onset.

The program provides opportunities for emerging adults to participate in biomedical clinical research (brain imaging) into the diagnosis, causes and treatments of these conditions. FEMAP also involves the evaluation of the program itself from the perspective of health system evaluation research.

Solutions 

Clinically, FEMAP provides definitive care for the early stages of mood/anxiety symptoms that have become severe enough to cause disruption in functioning for the emerging adult population (age 16-25). No physician referral is required and the service is located in a youth-friendly house in the community. There are no artificial end dates to treatment and all treatment decisions are made, together with the young person, based on clinical need. The service provides integration of addiction services, psychiatric services, psychological interventions, and family therapy, as clinically indicated according to the person's needs. Group therapies include a stabilization group for emerging adult women exposed to traumatic experiences and an anxiety group for emerging adults.

Biological research deliverables include the enrollment of the majority of participating emerging adults in health systems evaluation research. Program evaluation research is supported by the majority of emerging adults enrolled in the program for at least one time point. Over half of enrolled emerging adults also complete additional research time-points providing extremely valuable longitudinal data. This research aids in the evaluation of the program as a whole and helps determine the "cost for value" as well as other benefits/weaknesses of the model.

Impact 

The following publications are related to the health systems evaluation component of FEMAP research.

1. John-Baptiste A, Osuch E, Lihua L, Wanrudee I, Anderson KK. Healthcare utilization costs of emerging adults with mood and anxiety disorders in an early intervention treatment program compared to a matched cohort. Early Interv Psychiatry, 2019 Jan 27; epub ahead of print, Co-Principal Author, DOI: 10.1111/eip.12790.

2. Anderson KK, John-Baptiste A, MacDougall AG, Li L, Kurdyak P, Osuch E. Access and health system impact of an early intervention treatment program for emerging adults with mood and anxiety disorders. Can J Psychiatry, 2018 Nov 12; epub ahead of print, Co-Principal Author, DOI: 10.1177/0706743718809347.

3. Osuch E, Vingilis E, Summerhurst C, Demy J, Wammes M, Arcaro J. Process evaluation of a treatment program for mood and anxiety disorders in emerging adults: pre-entry factors, engagement and outcomes. Psychiatr Serv, 2018 Nov 1; epub ahead of print, Principal Author, DOI: 10.1176/appi.ps.201800219.

4. Arcaro J, Trembley P, Summerhurst C, Wammes M, Dash P, Osuch E. Emerging adults’ evaluation of their treatment in an outpatient mood and anxiety disorders program. Emerging Adulthood, 2018 Aug 28; epub, Senior Responsible Author, DOI: doi.org/10.1177/2167696818777339.

5. Armstrong S, Wammes M, Arcaro J, Hostland A, Summerhurst C, Osuch E. Expectations vs reality: The expectations and experiences of psychiatric treatment reported by young adults at a mood and anxiety outpatient mental health program. Early Interv Psychiatry, 2018 Mar 7; epub ahead of print, Senior Responsible Author, DOI: 10.1111/eip.12550.

6. Summerhurst C, Wammes M, Arcaro J, Osuch E. Embracing technology: Use of text messaging with adolescent outpatients at a mood and anxiety program. Social Work and Mental Health, 2017 Nov 30; 16 (3): 337-345, Senior Responsible Author, DOI: 10.1080/15332985.2017.1395782.

7. Arcaro J, Summerhurst C, Vingilis E, Wammes M, Osuch E. Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program. Psychol Health Med, 2017 Sep 1; 22 (8): 978-986, Senior Responsible Author, DOI: 10.1080/13548506.2016.1248449.

8. Summerhurst C, Wammes M, Wrath A, Osuch E. Youth Perspectives on the Mental Health Treatment Process: What Helps, What Hinders? Community Ment Health J, 2017 Jan 1; 53 (1): 72-78, Senior Responsible Author, DOI: 10.1007/s10597-016-0014-6.

9. Schraeder K, Vingilis E, Osuch E. Prevalence of substance use among adolescents in the First Episode Mood and Anxiety Program (FEMAP) versus adolescents in the general Ontario population. Journal of Substance Abuse and Alcoholism, 2016 Jul; 4 (2): 1046, Co-Principal Author

10. Osuch E, Vingilis E, Fisman S, Summerhurst C. Early intervention in mood and anxiety disorders: The First Episode Mood and Anxiety Program (FEMAP). Healthc Q, 2016 Jan 1; 18 Spec No (special): 42-9, Principal Author, DOI: 10.12927/hcq.2016.24485.

11. Osuch E, Vingilis E, Summerhurst C, Forster CI, Ross EE, Wrath AJ. Process evaluation of an early-intervention program for mood and anxiety disorders among older adolescents and young adults. Psychiatr Serv, 2015 Oct 1; 66 (10): 1113-7, Principal Author, DOI: 10.1176/appi.ps.201400256.

12. Bluhm RL, Covin R, Chow M, Wrath A, Osuch E. “I just have to stick with it and it’ll work”: experiences of adolescents and young adults with mental health concerns. Community Ment Health J, 2014 Oct 1; 50 (7): 778-86, Senior Responsible Author, DOI: 10.1007/s10597-014-9695-x.

13. Osuch E, Vingilis E, Ross E, Forster C, Summerhurst C. Cannabis use, addiction risk and functional impairment in youth seeking treatment for primary mood or anxiety concerns. Int J Adolesc Med Health, 2013 Jan 1; 25 (3): 309-14, Senior Responsible Author, DOI: 10.1515/ijamh-2013-0067.

14. Ross E, Vingilis E, Osuch E. An engagement and access model for healthcare delivery to adolescents with mood and anxiety concerns. Early Interv Psychiatry, 2012 Feb 1; 6 (1): 97-105, Principal Author, DOI: 10.1111/j.1751-7893.2011.00312.x.
 

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