Mclean Hospital

LEAP Center

Investigating First Episode Psychosis

Overview

The goal of the Laboratory for Early Psychosis (LEAP) Center is to develop collaborations, data systems, and methods to better understand the unique characteristics in first episode psychosis patient outcomes and treatment impacts.

The LEAP Center is one of the National Institute of Mental Health’s Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults With Mental Illness (ALACRITY) Research Centers. LEAP was funded by the National Institute of Mental Health (NIMH) in May 2019.

Why LEAP?

In order to meet its goals, the LEAP Center aims to take advantage of policy changes enhancing financing for first episode psychosis, practice changes in the field, and methods developed outside of mental health.

LEAP works closely with the Massachusetts Department of Mental Health, which receives Substance Abuse and Mental Health Services Administration funds earmarked for first episode care and collects standardized data on clinical care delivery and patient outcomes through MAPNET.

A program of the Department of Psychiatry at Beth Israel Deaconess Medical Center, MAPNET is supported by a first episode psychosis technical assistance center grant from the Massachusetts Department of Mental Health. MAPNET is dedicated to the early detection and treatment of mental illness, with the goal of connecting and supporting first episode psychosis service providers in Massachusetts.

Principal investigator and research assistant examines data on a computer screen
The LEAP Center will investigate first episode psychosis with the goal of improving patient care

LEAP also collaborates with coordinated specialty care clinics in Massachusetts as well as policy makers/regulators, stakeholders, and first episode psychosis experts from across the country. We have a common goal of mandating, standardizing, and supporting data collection from all first episode psychosis clinics.

Participating clinics include McLean OnTrack, Massachusetts General Hospital First-Episode and Early Psychosis Program, Massachusetts Mental Health Clinic Prevention and Recovery from Early Psychosis (MMHC PREP), Cambridge Health Alliance Recovery in Shared Experience (RISE), Boston Medical Center, and Prevention in Early Psychosis West (PREP West).

Core Support

In addition to its research projects, the LEAP Center includes an administrative and a methods core. The cores will support LEAP investigators and organize activities that bring together center staff, stakeholders in the community, and workers in this area from around the country and the world.

The LEAP Center will have its inaugural conference in the Spring of 2020 to highlight clinical research for stakeholders, the medical community, first episode psychosis clinics, and the public.

LEAP also has a unique built-in mechanism that gives junior investigators the ability to apply for funding for additional projects that will complement and build on the center’s activities.

Project Spotlight

The LEAP Center includes three scientific projects.

Project 1 will use the Massachusetts All Payer Claims Database to examine pathways to care and outcomes among patients within coordinated specialty care clinics and elsewhere.

Project 2 will review the data collected by the state from first episode psychosis clinics to assess and improve data collection quality, validate measures, and integrate perspectives from patients, families, clinicians, policymakers, payers, and other stakeholders.

Clinician and patients in group therapy
The McLean OnTrack clinic is one of many treatment programs for first episode psychosis that is sharing data with LEAP

Project 3 will define clusters of patients using longitudinal outcome data. This is the first step to understanding the unique clinical qualities (heterogeneity) of the disease. This project will also predict the cluster type for individual patients and examine the impact of coordinated specialty care treatment accounting for this clinical heterogeneity.

LEAP Center projects will have access to large amounts of data, both reported in claims databases and prospectively assessed over four years. Data collection will include comprehensive clinical measures (diagnosis, treatment, utilization, symptoms), cognition, community functioning, patient/family reports, and clinical and clinic-level measures. This will allow center investigators to conduct extensive analyses that can contribute to our understanding of heterogeneity in first episode psychosis.

Leadership

Dost Öngür MD, PhD, Center Director

Dr. Öngür is the chief of the Psychotic Disorder Division at McLean Hospital. He is also the director of McLean’s Schizophrenia and Bipolar Disorder Research Program and the William P. and Henry B. Test Professor of Psychiatry at Harvard Medical School. In addition to his clinical work, he receives funding from the National Institute of Mental Health and other sources for his research using brain imaging techniques to study chemical abnormalities in patients with schizophrenia and bipolar disorder.


John Hsu, MD, MBA, Center Director

Dr. Hsu is the director of the Program for Clinical Economics and Policy Analysis at the Mongan Institute for Health Policy at Massachusetts General Hospital. He studies innovations in health care financing and delivery, and their effects on medical quality and efficiency. With a background in internal medicine, health services research and clinical epidemiology, and health care finance and management, Dr. Hsu brings clinical, population, and business perspectives to these studies. In his work, he primarily uses large automated and electronic health record data sets, often exploiting natural experiments from both clinical and behavioral economics perspectives.


Miguel Hernán, MD, DrPH, Center Director

Dr. Hernán is the Kolokotrones Professor of Biostatistics and Epidemiology at the Harvard School of Public Health. His research is focused on learning what works for the treatment and prevention of diseases like cancer, cardiovascular disease, and HIV infection. He collaborates on design analyses of healthcare databases, epidemiologic studies, and randomized trials. For over a decade, he has coordinated the HIV-CAUSAL Collaboration, a multinational consortium of prospective studies from Europe and the Americas.