Patterns of service utilization and its relation to outcome in a first-episode psychosis program

NAVIGATE is a comprehensive, manual-based intervention developed in the United States for young people experiencing first-episode psychosis (FEP). It comprises four core components: medication management, individual resilience training (IRT), supported employment and education (SEE), and a family psychoeducation program (FEP). This study aimed to describe NAVIGATE utilization patterns in Israel and their relationships to outcomes. Demographic and diagnostic information, service-utilization data, and functioning and symptom ratings were collected from clinical registries of 135 individuals who participated in NAVIGATE at three Israeli clinics from 2017 through 2021. The sample was mostly (72 %) men (M = 23.9 years old, SD = 5.4) who, on average, engaged in the program for more than 1 year. The IRT component was the most frequently attended (M = 25 sessions, SD = 24.9). Participants who attended more sessions in any component(s) showed higher functional and symptomatic improvement. Session intensity (by session intervals) was significant only for SEE: the more intensity, the more functioning and symptoms improved. Three distinct service-utilization clusters were identified: low use of all components; high IRT and low use of others; and moderate IRT, high FEP, and low others. The third cluster showed the highest improvement, but all clusters correlated with improved outcomes. The NAVIGATE program in Israel yield significant clinical and functional improvements across service-use patterns even when attendance was lower than the full offering. That a comprehensive, team-based intervention delivered flexibly can accommodate the rapidly changing needs of young people with FEP is encouraging, with important implications for policy and practice.