Approximately 107,000 California residents are estimated to experience a first psychosis episode each year (Radigan et al., 2019). California currently has active programs providing Early Psychosis (EP) services across multiple counties. However, these programs offer different services, follow different treatment models, and measure treatment impact differently.

EPI-CAL was created to help address these issues.

At EPI-CAL, our goals are to support provision of high-quality EP care to all Californians and to promote recovery and better outcomes through a learning health care network approach. EPI-CAL is an initiative that represents a partnership between counties, providers, academic institutions, and the state. Our leadership is actively engaged and providing clinical services in community mental health settings.

EPI-CAL is comprised of multiple components and includes extensive clinical training, technical assistance and consultation, outcomes data collection through a learning health care network, and fidelity assessments and monitoring.

In 2018-2019, five counties (Los Angeles, Orange, San Diego, Solano and Napa) and One Mind committed funding to develop the EPI-CAL Learning Health Care Network (LHCN). In 2019, the UC Davis and UCSF teams secured funding from National Institute of Mental Health through the national EPINET project to expand the network to 2 more counties (San Mateo and Sacramento) and 5 university programs (UCSF, UC Davis, Stanford, UCLA, UCSD). Since that time, Sonoma, Stanislaus, Lake, Kern, Ventura, and a multicounty hub-and-spoke collaborative (Nevada, Mono, Colusa) have chosen to join the LHCN. The LHCN supported the collaborative development of a harmonized outcomes battery based on the preferences of service users, support persons, providers and community partners as well as a data collection application, Beehive, to support statewide collection and evaluation of CSC outcomes. EPI-CAL's LHCN initiated the remote collection of fidelity to CSC best practices using the FEPS-FS.

In 2020, California's AB1315 EPI Plus legislation supported the creation of the EPI-CAL Training and Technical Assistance (TTA) program, which was designed to provide TTA to 5 counties' (as well a hub-and-spoke collaboration) CSC programs. This funding supported a framework for TTA on the core components of CSC for FEP, including county and program consultation for program development; supporting integration of lived experience and family/support person perspectives; incorporating diverse perspectives to ensure we are equitably supporting underserved communities; developing teams to support training and consultation in CSC. We also further developed a remote approach to fidelity assessment using the FEPS-FS.

In 2022, DHCS supported the expansion of our LHCN and TTA to all counties receiving funding from the Mental Health Block Grant 10% Set-aside for Early Psychosis care. With this funding, we expanded our EPI-CAL program to many EP programs and counties across the state. We also developed a modified FEPS-FS fidelity evaluation to assess programs that serve youth at clinical high risk for psychosis. In 2023, we were contracted by the BHSOAC to support the development of an additional 9 programs through the CYBHI Round 5 funding.

In 2025, our team was designated as the DHCS-funded Center of Excellence for Coordinated Specialty Care (CSC) for First Episode Psychosis (FEP) to work with California counties to deliver high-quality CSC. These are areas of continued development, and we are excited to collaborate with current and new partners as part of BH-CONNECT and BHSA to build an EBP for CSC that serves the needs of all Californians. To learn more about the COE, visit the COE landing page.

Beehive is the data collection and visualization software platform that EPI-CAL Early Psychosis (EP) programs will use to incorporate information about a service user's recovery and wellness into their mental health care. Beehive both facilitates the collection of this recovery and wellness information and allows program staff and providers real-time access to it, with the ultimate goal of incorporating this information into care. Service users, family members or support persons, and providers complete surveys every six months throughout the service user's time in the program.

Data Collection: Service users and their self-identified support persons will complete surveys about their experiences. These surveys will ask about symptoms, treatment, and recovery. Individuals will complete surveys on a tablet at the clinic for in-person visits, or on their computer or smartphone if engaging in telehealth. EP providers will also complete surveys in the web application.

Data Visualization: The web application will provide clinic staff and providers with data visualizations of completed surveys. EP providers are encouraged to share these visualizations with service users during appointments. Incorporating this data into care may facilitate conversations regarding treatment goals, encourage shared decision-making, and enhance service users' involvement in their care. Clinic administration can also use this data to monitor treatment outcomes and consider factors which impact recovery.

Beehive is being developed in collaboration with Quorum Technologies, Inc.