(PS2-84) Focused Integrated Team-based Treatment for Bipolar Disorder (FITT-BD): Implementing of the Chronic Care Model to Patients with Serious Mental Illness

Background: First-line treatments for serious mental illnesses (SMIs), such as psychotherapy, are often costly, difficult to access, and lacking in trained providers. Traditional models of treatment delivery also do not often take into account the non-linear course of SMIs. The Collaborative Chronic Care Model (CCM) incorporates six components for treating chronic conditions like SMIs: self-management support, clinical information systems, delivery system redesign, decision support, health care organization, and community resources. We will present a novel program that applies the CCM model to the treatment of bipolar disorder: the Focused Integrated Team-based Treatment for Bipolar Disorder (FITT-BD).

Methods: FITT-BD incorporates the CCM components self-management and decision support and delivery system redesign through a stepped-care model that delivers a variety of evidence-based therapies (e.g. CBT, DBT, ACT, medication management, and individual and group psychotherapy) based on how the patient is functioning at a given time. The FITT-BD online platform is a clinical information system, allowing patients to set individualized treatment goals, complete assessments or patient-reported outcomes, and perform web-based self-guided interventions. FITT-BD is also collaborative,  with weekly team meetings of multi-disciplinary members to discuss the patients’ treatment needs. Finally, FITT-BD advocates for organizational change across healthcare systems to support its innovative stepped care model for treatment delivery by updating billing codes, implementing training programs for non-professionals and improving integration of patient-reported outcomes with clinical care.

Results: The FITT-BD program has treated 191 patients over the past two years. Of these, 66 have consented to sharing their de-identified data. Of these patients, 40 (60.6%) met criteria for a current or past diagnosis of bipolar I disorder (BDI), 14 (21.2%) met criteria for a current or past diagnosis of bipolar I disorder (BDII), and 22 (33.3%) met criteria for a current or lifetime mood disorder with psychotic features. Patients are predominantly white (n=56; 85.8%) and have a mean age of 42.12 (SD = 15.70). Fifty percent of patients (n=33) are currently employed, 30.3% (n=20) live at home, and 33.3% (n=22) live in temporary housing.   

Conclusion: FITT-BD is an innovative treatment delivery program of established psychosocial treatments for bipolar disorder. FITT-BD increases access to care by shortening wait times for joining the clinic and comparing outcomes over time to usual care.  This paper will also examine moderators of outcomes to improve the personalization of treatments and disseminate the program at other treatment centers.