Objective: NAVIGATE is a comprehensive treatment program for first episode psychosis developed and implemented in the US that has been found to be effective. The purpose of the present study was to describe the first initiative of NAVIGATE's implementation outside the US, and to present data collected in Israel from the first two clinics focusing on NAVIGATE clients' characteristics, components utilization and retrospective clinician ratings of change. Methods: Administrative data for 61 NAVIGATE clients in Israel and retrospective ratings of NAVIGATE clinicians were analysed. Results: The duration of untreated psychosis was 4.4 months (SD = 6.8). Clients were mostly referred to NAVIGATE from psychiatric hospitals (n = 29, 50.9%) and community mental health agencies (n = 20, 35.1%). The individualized resiliency training (IRT) component had the highest client utilization rate (n = 53, 98.1%) with a monthly average of M = 2.32 sessions (SD = 2.75). Clinicians' retrospective ratings indicated that 66% of the clients (n = 33) had improved in at least one life domain, with the most common improvement in employment (n = 28, 56%), recovery (n = 24, 50%), and symptoms severity (n = 23, 47%). Conclusions: Our findings reveal that NAVIGATE can be implemented outside the US within a different social and cultural context and different mental health system. The utilization rates of the program components and clinicians' retrospective ratings indicated positive change among most of NAVIGATE clients, pointing to the potential value of NAVIGATE above and beyond different countries and health systems.
Bibliographical noteFunding Information:
This study was funded in part by the Laszlo N. Tauber Family Foundation. Funding information
NAVIGATE is a comprehensive treatment program for FEP developed in the US as part of the Recovery After an Initial Schizophrenia Episode (RAISE) initiative funded by the National Institute of Mental Health (Kane et al., 2015 , 2016 ; Mueser et al., 2015 ). NAVIGATE's main goal is to help clients and family members navigate the confusing experience of a FEP and the complexities of the mental health system towards the desired outcome of recovery (Robinson et al., 2018 ). NAVIGATE's core treatment components include individualized resiliency training (IRT), family education program (FE), supported employment and education (SEE) and personalized medication management (PMM). A study comparing randomized NAVIGATE with routine community‐care sites revealed improved treatment retention, quality of life and functional and clinical outcomes after a 2‐year follow‐up among NAVIGATE completers (Kane et al., 2016 ), and a more recent study reported the benefits among NAVIGATE completers also at 5‐year follow‐up (Robinson et al., n.d. ). Other studies focusing on the first 2 years of participation in the program found that NAVIGATE recipients had higher rates of medication adherence (Robinson et al., 2018 ), perceived autonomy support (Browne et al., 2017 ) and community engagement (Rosenheck et al., 2017 ), and that the program was feasible (Rosenheck et al., 2016 ) and delivered with high fidelity in real‐world settings (Mueser et al., 2019 ).
We would like to express our gratitude for the collaboration in data collection to both NAVIGATE clinics: The community mental health clinic of the Jerusalem Mental Health Centre in Kiryat Yovel and the NAVIGATE clinic in the Headspace program, Bat Yam. We are grateful for the ongoing collaboration of Professor Max Lachman from the Laszlo N. Tauber Family Foundation and Dr. Tal Bergman Levy and Danny Budowski from the Ministry of Health. This study was funded in part by the Laszlo N. Tauber Family Foundation.
© 2020 John Wiley & Sons Australia, Ltd
ASJC Scopus subject areas
- Psychiatric Mental Health
- Psychiatry and Mental health
- Biological Psychiatry