Psychosis Clinical & Research Program

The First-Episode and Early Psychosis Program (FEPP) offers highly specialized evaluation, treatment and education for people who are experiencing psychosis for the first time.

The FEPP evaluates and treats people who:

• Are experiencing psychosis for the first time
• Are between the ages of 14 and 35
• Are residents of Greater Boston
• Our program offers:
• Medical and psychological evaluation
• Diagnostic second opinion consultations
• Medication treatment
• Education and family support
• Cognitive behavioral therapy, a form of talk therapy

Screening process: If you are interested in treatment at the FEPP, please click on the link below for the referral form. The form can be filled out by the patient, family member, or provider.

https://redcap.link/referralPCRP

The screening process may take time, and you may be contacted for additional information as all referrals are screened for clinical appropriateness. Submitting the referral is not a guarantee of treatment.

During your initial visit, you will meet with a member of our clinical team. The clinical team member will ask you questions about your mental health, medications and medical history and we will determine what treatment program will best meet your needs. You may be offered ongoing treatment through the FEPP or you may be directed to other appropriate treatment options. An initial visit is not a guarantee of ongoing treatment.

Program Duration: If you enter the program, program participation is limited to two years. At that point, we will evaluate your need for continued treatment and can assist with a transition to appropriate care.

The Recovery and Ongoing Care Clinic (ROCC) at Massachusetts General Hospital evaluates and provides psychiatric medication treatment to people with ongoing psychotic illness who:

• Have received a diagnosis of a psychotic disorder (such as schizophrenia or schizoaffective disorder) more than 5 years ago
• Are adults (18 or older)
• Are residents of Greater Boston

ROCC is appropriate for patients who are stable on currently effective medications, as well as those who have not yet found an effective medication and would like to try new treatments. At this time, psychotherapy and case management are not available through ROCC. Note that this program primarily serves former patients of FEPP (i.e., FEPP “graduates”) who no longer require the intensive coordinated specialty care that FEPP provides but need to receive their medical care at MGH.

Screening process:

If you are interested in treatment at the ROCC, please click on the link below for the referral form. The form can be filled out by patients, family members, or providers.

https://redcap.link/referralPCRP

The screening process may take time, and you may be contacted for additional information as all referrals are screened for clinical appropriateness. Submitting the referral is not a guarantee of treatment.

The Clozapine Clinic at Massachusetts General Hospital evaluates and provides psychiatric medication treatment to people with psychotic illness who:

• Are adults (18 or older)
• Are residents of Greater Boston
• Are taking the antipsychotic clozapine or are interested in a clozapine trial

Clozapine is the most effective antipsychotic medication, and timely consideration of clozapine treatment can be lifesaving. Clozapine should be tried as soon as treatment-resistance is apparent which may be within 4 to 6 months of unsuccessful, sequential treatment with two other antipsychotics. Administering and managing clozapine safely requires expertise, and clinicians in the MGH Clozapine Clinic have years of expertise in successfully administering clozapine. The MGH Clozapine Clinic also serves as a headquarters for providing centralized guidance and support to clozapine prescribers nationwide.

If you are interested in treatment at the Clozapine Clinic, please click on the link below for the referral form. The form can be filled out by patients, family members, or providers.

https://redcap.link/referralPCRP

The screening process may take time, and you may be contacted for additional information as all referrals are screened for clinical appropriateness. Submitting the referral is not a guarantee of treatment. Submitting the referral is not a guarantee of treatment. In some cases, we may recommend a referral to our community partner, North Suffolk Mental Health Association which whom we have a clozapine collaborative relationship.

We provide clinical expertise and guidance to MGH clinicians and the larger psychiatric community for their patients who have not adequately responded to treatment or for those who are seeking diagnostic clarification.

Psychiatric providers: If you are interested in a one-time consultation, please click on the link below for the consult referral form.

https://redcap.link/referralPCRPconsults

Patients and family members: If you are interested in a consultation, please discuss this with your treating clinician. The referral form must be filled out by the current prescribing provider.

The screening process may take time, and you may be contacted for additional information as requests are screened for clinical appropriateness. Submitting a request is not a guarantee of consultation appointment. Note that patients seen in the Psychosis Consultation Service will not become patients of the Psychosis Clinical and Research Program and no responsibility for their treatment is assumed. All responsibility for ongoing treatment remains with the current clinicians, including arranging for any further treatments or tests that are recommended.

Our healthcare system is fragmented, and the mental healthcare system is stretched thin, with too few psychiatrists. This can make it challenging to access mental health services, so don’t give up after your first try didn’t work.

If you need help with a psychiatric emergency, go to your nearest emergency room or call 911. Do not go to an emergency room to simply get a referral for outpatient care. Emergency rooms are completely overwhelmed during the pandemic.

Here are a few steps to try if you are looking for a psychiatrist:

1. Contact your PCP (often the best first step)

PCPs often have access to a network of mental health providers to whom they can refer you. In addition, many psychiatrists in larger healthcare systems can only see you if you have a PCP in that healthcare system. You may need to sign up for a PCP in that system. For example, a psychiatrist at MGH can only see you if you have an MGH PCP. If you do not have a PCP, you can call your insurance company (look for the main number of the back of your insurance card) and ask for a list of PCPs who are accepting new patients.

2. Contact your university student health service (good step if you are part of a university)

If you are connected to a university (e.g., if you are a student) contact your university’s medical service.

3. Contact your insurance

Insurances in theory have a list of contracted healthcare providers. However, their lists are often not up-to-date, and even if you are given an accurate list, you are still left with making phone calls to individual providers or clinics. If you do get a list, you may want to call many providers on it to increase your chances of making a successful connection (some providers may not be taking new patients, some may have moved or retired).

4. Contact a university’s outpatient department of psychiatry

Phone numbers for appointments are usually easy to find using the hospital’s website. However, wait lists are usually very long and insurance issues (among others) may prevent you from receiving care. In some cases, contacting a specialty service directly (if you know your diagnosis) may work.

• Example for a university specialty service:
• MGH Psychosis Clinical and Research Program. This program specializes in the care of people with psychosis (schizophrenia or severe bipolar disorder). Call the clinic at 617-643-1175 to find out if you are eligible for care.

5. Contact independent psychiatric care providers (good if you know your diagnosis)

This can be an individual practitioner in private practice or an outpatient psychiatric clinic (community mental health clinic).

Wait lists and insurance issues (ability to pay if private) may get in the way of receiving care.  Most psychiatrists in private practice do not accept insurance. Outpatient psychiatric clinics are sometimes called community mental health centers. Typically, you need to see a social worker first for an “intake” before you can see a psychiatrist. Outpatient clinics locations and contact information can be identified through an internet search. 

• Example for a community mental health provider:
• North Suffolk Mental Health Association (NSMHA). This organization runs several clinics including the Freedom Trail Clinic (FTC) in downtown Boston. Appointments at FTC can be arranged by calling 617-912-7800.  The NSMHA website is https://northsuffolk.org/

6. Contact your local Emergency Services Program (ESP)

Every city or town in Massachusetts has a designated emergency services program (ESP) whose role is to manage mental health treatment for the community. While ESPs focus largely on people with Medicaid or those who have no health insurance, they can also be more generally helpful in suggesting ways to access care, regardless of insurance type. A list of ESPs by town can be found here: https://www.mass.gov/info-details/emergency-services-program-contact-information

• Example for an ESP:
• Boston Emergency Services Team (BEST): BEST is the ESP for people who live in Boston, Cambridge and Somerville. Despite their name, they may be able to review your case and guide you about what to do next, even if it is not an emergency. The Boston team can also help you find your local team. The phone number for BEST is 800-981-4357. Their website is https://northsuffolk.org/services/emergency-services/boston-emergency-services-team/

7. Contact the NAMI Compass Helpline

The National Alliance on Mental Illness (NAMI) Compass Helpline can provide information about how to access mental health treatment in Massachusetts. Their phone numbers are 617-704-6264 or 800-370-9085. Their email is compass@namimass.org. Their website is https://namimass.org/nami-mass-compass-helpline/

The Freedom Trail Clinic (FTC) - For more than 30 years, the Massachusetts General Hospital's Psychosis Clinical and Research Program has worked with a strong community partner, North Suffolk Mental Health Association, which provides community-based care for psychiatric patients, including those with schizophrenia and other psychotic disorders and those who require clozapine treatment or long-acting injectable antipsychotics. Please contact the Freedom Trail Clinic at 617-912-7800 for more information about their clinical program.

• Drew Coman, PhD
• Nicole DeTore, PhD
• Hamdi Eryilmaz, PhD
• A Eden Evins, PhD
• Kelly Irwin, MD
• Yoshio Kaneko, MD
• Gina Kuperberg, MD, PhD
• Dara Manoach, PhD
• Robert Mealer, MD, PhD
• Dimitrios Mylonas, PhD
• John Tyson, MD
• Shreedhar Paudel, MD, MPH
• Baktash Babadi, MD, PhD
• Jacqueline Clauss, MD, PhD
• Lauren Utter, PsyD
• Carol Lim, MD
• Hollie Swire, LICSW
• Sarah MacLaurin, PMHNP