Center for Practice Innovations Brings Evidence-Based Practices to NYS Behavioral Health Providers

What is CPI?

The Center for Practice Innovations (CPI) supports the New York State Office of Mental Health’s (OMH) mission to promote the widespread availability of evidence-based practices (EBPs) to improve mental health services, ensure accountability, and promote recovery-oriented outcomes for consumers and families. CPI serves as a key resource to OMH by spreading those practices identified by OMH as most critical to accomplish OMH’s system-transformation initiatives.

Located at the New York State Psychiatric Institute, CPI is directed by Lisa Dixon, M.D., M.P.H. and employs 50+ staff members, many with faculty appointments to the Columbia Psychiatry Department. CPI is celebrating its 10th anniversary of working with behavioral health care and other providers.

CPI helps practitioners develop knowledge and skills and through its training efforts focuses on practice change – that is, practitioners learn to provide the most effective services and change the ways in which they interact with behavioral health consumers. At the same time, CPI works with agency leaders, managers and supervisors to help them with implementation of these changes in their programs and settings. 

CPI has shared its experience with training and implementation support by contributing to the professional literature. A list of recent journal articles can be found at the end of this article.

What are Evidence-Based Practices?

OMH is dedicated to providing mental health services that are based on the best evidence available and improve outcomes and quality of life for people with mental illness. Over the past decade, research in the field of mental health has demonstrated that there is consistent scientific evidence that some specific practices work well in improving outcomes in the lives of individuals with a serious mental illness. These specific practices, called evidence-based practices (EBPs), are interventions for which there is consistent scientific evidence showing that they improve consumer outcomes. National studies have shown that a majority of individuals diagnosed with a serious mental illness do not have access to these EBPs; hence OMH has funded the CPI to help implement and sustain EBPs statewide.

What are CPI’s EBP Initiatives?

Assertive Community Treatment (ACT): ACT is a community-based approach that meets people where they are by bringing a full mental health treatment team out of the office and into any setting where individuals choose to meet. The ACT Institute provides training, support, and consultation to ACT providers across New York State. 

Focus on Integrated Treatment (FIT): The FIT initiative helps programs implement integrated treatment for co-occurring mental health and substance use disorders (COD), a proven strategy for helping people sustain and maintain recovery. The treatment emphasizes the importance of people setting their own recovery goals (such as education, employment, re-connecting with children and families) and underscores the key role of peers in the recovery process. One important focus is on tobacco cessation services.

Individual Placement and Support (IPS) model of Supported Employment: CPI offers training and support to PROS programs and OMH state facility clinics across New York State to bring consumers the IPS approach to supported employment. Because of the high rates of employment attained by consumers participating in high-fidelity IPS programs across the country, IPS has become the gold standard for supported employment. Its focus is on helping consumers find and keep competitive jobs in the real world. A recent study led by Dr. Paul Margolies suggests that when a specific approach to supported employment (Individual Placement and Support, or IPS) is implemented well, as self-assessed by mental health program sites, it is associated with higher employment rates, which were sustained over time.

OnTrackNY: OnTrackNY is an innovative treatment program for adolescents and young adults who recently have had unusual thoughts and behaviors or who have started hearing or seeing things that others don’t. OnTrackNY helps people experiencing first episodes of psychosis achieve their goals for school, work, and relationships. Programs are located throughout New York State. We caught up with Dr. Ilana Nossel to discuss her exciting new Psychiatric Services article, “Results of a Coordinated Specialty Care Program for Early Psychosis and Predictors of Outcomes.” OnTrackNY is a type of CSC that provides a multidisciplinary team approach to treatment, including medication, psychotherapy, support with school and work, case management, and family support to help young people recover from psychosis, stay on track, and meet their goals.

Suicide Prevention: The Suicide Prevention-Training, Implementation and Evaluation program (SP-TIE) develops suicide prevention training materials include online learning modules, provides consultation and disseminates evidence-based assessment tools and interventions to health care professionals.  Suicide prevention involves identification, assessment, treatment and support for at-risk individuals as well as upstream efforts at preventing the development of suicide risk. Training is geared towards gatekeepers (e.g. school counselors, police, clergy), clinicians responsible for identifying and treating suicidal individuals and policy makers/administrators responsible for creating an environment that promotes quality care for suicidal individuals. Dr. Barbara Stanley, director of the program, is conducting a large scale NIMH funded trial of zero suicide implementation strategies in approximately 200 outpatient behavioral health clinics in New York State. The Zero Suicide model is a comprehensive national approach to reducing suicides within health care systems. Dr. Stanley’s grant is the first to test the Zero Suicide model in a statewide outpatient implementation.

Wellness Self-Management: Wellness Self-Management (WSM) is a curriculum-based clinical practice designed to assist adults to effectively manage serious mental health problems. The topics covered include a number of research-informed approaches that are organized into a comprehensive and coordinated set of practices. The WSM program is based on Illness Management and Recovery, a nationally recognized evidence-based practice for adults with serious mental health problems. The curriculum is organized into a 57-lesson personal workbook.

For further information about CPI, please contact Paul Margolies, Ph.D. at Paul.Margolies@nyspi.columbia.edu and visit http://practiceinnovations.org/.

Center for Practice Innovations
Recent Contributions to the Professional Literature

Patel SR, Margolies PJ, Covell NH, Lipscomb C, & Dixon LB: Using instructional design, Analyze, Design, Develop, Implement, and Evaluate (ADDIE), to develop e-Learning modules to disseminate Supported Employment for community behavioral health treatment programs in New York State.  Frontiers in Public Health 6:113, 2018   doi: 10.3389/fpubh.2018.00113.

Margolies PJ, Humensky JL, Chiang I, Covell NH, Jewell TC, Broadway-Wilson K, B Gregory R, Scannevin G, & Dixon LB:  Relationship Between Self-Assessed Fidelity and Self-Reported Employment in the Individual Placement and Support Model of Supported Employment. Psychiatric Services 69: 609-612, 2018

Talley, R, Chiang, I, Covell, NH, & Dixon, LB:  Comparative Initial and Sustained Engagement in Web-Based Training by Behavioral Healthcare Providers in New York State. Journal of Technology in Behavioral Science 3, 41-48, 2018

Humensky J, Scodes J, Wall M, Malinovsky I, Marino L, Smith T, Sederer L, Nossel I, Bello I, & Dixon L: Disability Enrollment in a Community-Based Coordinated Specialty Care Program. American Journal of Psychiatry 174:1224-5, 2017

Huz S, Thorning H, White CN, Fang L, Smith BT, Radigan M, Dixon LB: Time in Assertive Community Treatment: A Statewide Quality Improvement Initiative to Reduce Length of Participation. Psychiatric Services 68:539–541, 2017

Margolies, PJ, Humensky, JL., Chiang, I, Covell, NH, Broadway-Wilson, K, Gregory, R, Jewell, TC, Scannevin, G, Baker, S, & Dixon, LB: Is there a role for fidelity self-assessment in the Individual Placement and Support model of supported employment?  Psychiatric Services, 68: 975- 978, 2017

Bello I, Lee R, Malinovsky I, Watkins L, Nossel I, Smith T, Ngo H, Birnbaum M, Marino L, Sederer LI, Radigan M, Gu G, Essock S, & Dixon LB: OnTrackNY: The Development of a Coordinated Specialty Care Program for Individuals Experiencing Early Psychosis. Psychiatric Services 68:318-20, 2017