# Understanding Capacity to Treat First Episode Psychosis with a Hybrid Telemental Health Delivery Model: A Needs Assessment of Ohio Community Mental Health Centers

## TL;DR

This study assesses Ohio mental health centers' ability to treat first episode psychosis using a mix of in-person and virtual care, finding potential in hybrid models.

## Contribution

A novel mixed-methods needs assessment identifies barriers and success factors for hybrid telemental health in treating first episode psychosis.

## Key findings

- Responding CMHCs offered an average of 10.96 of 17 CSC services for FEP.
- 75% of agencies believed expanding telemental health would benefit patients.
- Three success factors for virtual service expansion were identified: adapting care, ensuring access, and adjusting workflows.

## Abstract

Coordinated specialty care (CSC) is considered the gold-standard treatment for individuals experiencing first episode psychosis (FEP). However, CSC teams are resource-intensive, motivating the development of a hybrid delivery approach where community mental health centers (CMHCs) collaborate with an academic medical center to deliver a mix of in-person and virtual services. To inform the development of this hybrid approach, a needs assessment was conducted, evaluating the existing capacity of Ohio CMHCs to treat FEP and identifying barriers to expanded use of telemental health. CMHC administrators throughout Ohio whose agencies primarily provide mental health services were surveyed using a novel instrument. A concurrent mixed methods approach combined multivariable analysis of cross-sectional survey data with thematic coding of responses to open-ended questions. The 56 responding CMHCs on average offered 10.96 of 17 services associated with CSC for FEP. Agency size was positively associated with number of service offerings, but rurality was not. Most agencies perceived gaps in their care for patients with FEP, particularly rural CMHCs. 75% believed that telemental health service expansion would benefit patients. Thematic analysis revealed three success factors for expanded telemental health usage: adapting care to virtual assessment, ensuring patient access, and adjusting workflows for virtual delivery. Responding CMHCs generally agreed that care for individuals with FEP could be improved and saw potential in expanded use of virtual services. Hybrid models may represent a valuable opportunity to overcome conventional barriers to CSC availability, but their development must account for current CMHC resource infrastructure and workflows.

The online version contains supplementary material available at 10.1007/s10488-025-01437-y.