New Journeys and first episode psychosis

New Journeys is evidence-informed recovery-oriented outpatient care for individuals aged 15-40 who are experiencing new and unexpected changes in their perceptions and thinking, referred to as "first episode psychosis" (FEP). There are teams across the state of Washington that offer comprehensive and personalized support.

Overview

New Journeys is evidence based coordinated specialty care (CSC), adapted to meet the needs of people in Washington. New Journeys multidisciplinary teams provide early intervention for first episode psychosis through an array of treatment services and recovery support services that are delivered at a higher intensity than those offered in regular outpatient settings. The model aims to make early identification and treatment of psychosis a universal practice. The sooner an individual accesses appropriate care, the better the outcomes.

How does New Journeys work?

New Journeys is a multi-disciplinary team of behavioral health professionals and peer support specialists who work together to provide individual therapy, family therapy, psychopharmacology, peer support, education and/or employment support and case management to help those experiencing symptoms to achieve their own goals.

New Journeys services are offered in a community-based setting, whether in the office, at home, school or in the community, based on an individual’s own needs. Treatment goals are based on an individual’s own definition of what matters to them in their recovery journey. New Journeys teams use shared decision-making to support individuals in navigating their treatment and recovery goals.

Service components include:

Screening and assessment
Individual and/or group psychotherapy
Supported employment and education
Family psychoeducation and support
Psychiatry
Peer support
Referrals to other community-based services depending on individual need

New Journeys through video

Learn about New Journeys through a series of short videos from New Journeys.

New Journeys Programs (1-minute overview)
Primary Care Physicians

Learn more about New Journeys

New Journeys, a CSC mode for First Episode Psychosis

Locations

New Journeys is currently available in the following areas:

For more information, visit the New Journeys website.

How to make a referral

If you or someone you know has been experiencing symptoms of psychosis for 1 week up to two years, are between the ages of 15 to 40, and live in an area where New Journeys is available, please consider making a referral to New Journeys for additional screening. Anyone can make a referral to New Journeys, either by filling out the online referral form, or by contacting a team directly.

Every individual’s experience is unique, and it can take time to understand what may be going on with an individual who is experiencing symptoms. New Journeys teams are trained and receive specialized support for screening and differential diagnosis. They can also assist in providing referrals and warm hand-offs to other services, if deemed a more appropriate treatment match.

General admission criteria

This matrix below provides a general guide that outlines who may be an appropriate treatment match for New Journeys. Please consult with a team near you for screening and assessment.

Age range	15-40 years old
Diagnosis	Schizophrenia Schizoaffective disorder Schizophreniform disorder Brief psychotic disorder Delusional disorder Major Depressive disorder with psychotic features Bipolar disorder with psychotic features Other specified psychotic disorder
Duration of illness / Onset of illness	Greater than or equal to (>) 1 week Less than or equal to (<) 2 years For individuals with affective psychosis, please reference the earliest onset of psychotic symptoms, which may or may not align with earliest onset of any symptoms of the associated affective disorder.
The psychosis in NOT known to be caused by:	Pervasive developmental disorder and/or Autism Spectrum Disorder Psychotic disorder due to another medical condition including medication induced psychotic disorder The temporary effects of substance use or withdraw (individuals who use substances may still be referred)

Early intervention treatment manuals and toolkits

New Journeys policy, program, and procedure manual
Medical Workup Considerations - Psychosis Screening
National Institute of Mental Health (RAISE, OnTrack NY, and NAVIGATE program manuals)
Center for Practice Innovations’ (CPI’s) consumer and family portal (videos, brochures, and workbooks)
Practice parameter for the assessment and treatment of children and adolescents with schizophrenia (article)
Information for providers (SAMHSA resource on the National Association of State Mental Health Program Directors website)
Allied Professionals Toolkit
NAVIGATE Coordinated Specialty Care Manuals for Team Members
OnTrack New York Peer Specialist Treatment Manual
Individual Placement and Support—A Supported Employment Model (SAMHSA toolkit)
SAMHSA Early Serious Mental Illness Treatment Locator
The American Psychiatric Association Practice Guideline for Treatment of Patients with Schizophrenia

Mysteries of the brain training modules

The case for early intervention

Research indicates that many people experience long delays before receiving treatment after the initial onset of a psychotic disorder. These delays are associated with poorer outcomes across the lifespan. The interval during which a person first begins to exhibit symptoms of psychosis to when they first receive any treatment is referred to as the duration of untreated psychosis, or DUP. And although the World Health Organization recommends that individuals initiate treatment within 3 months after they first begin to experience symptoms, in the United States, the median DUP is 74 weeks.

Untreated psychosis can lead to:

Increased substance use
Decreased effectiveness in future use of antipsychotic medications
Increased suicidality
More hospital visits
Criminal Justice system involvement
Risk of homelessness
Premature death

In 2008, The Recovery After an Initial Schizophrenia Episode (RAISE) research trials in the United States identified coordinated specialty care (CSC) as an evidence-based practice that provides multidisciplinary, recovery-oriented team support for youth and young adults experiencing symptoms and their caregivers.

Compared to treatment as usual, those participating in CSC were:

More likely to stay in treatment
Experienced greater reductions in symptoms
Demonstrated greater improvements in quality of life
Participated more in work or school

The sooner a person accesses appropriate care following the onset of symptoms, the better their outcomes will be, and the more tools and supports they will have to define their own personal, recovery journey. Public education about psychosis can help reduce stigma and provide information to community partners and families to ensure early detection and access to care.

Partners

New Journeys is a collaboration between Health Care Authority, the University of Washington SPIRIT Center, and the Elson S. Floyd College of Medicine of Washington State University.

(Updated May 2025)