Community Safety Response (CSR) programs increasingly provide non-police alternatives to behavioral health crises, but their role in addressing substance use calls remains poorly understood. This qualitative study examined how municipal stakeholders in Denver, Colorado and San Francisco, California perceive and operationalize CSR protocols for substance use-related emergencies. Between 2021 and 2023, we conducted 82 semi-structured interviews and 32 field observations with 911 dispatchers, law enforcement, city officials, and alternative responders from Denver and San Francisco's respective CSR programs. Transcripts and field notes were analyzed using thematic analysis to identify attitudes toward substance use, decision-making processes for call deployment, and barriers and facilitators to routing of substance use related calls to alternative response. Although written protocols permitted non-police response to substance use calls absent violence or weapons, findings revealed a gap between policy and practice. Dispatcher and responder discretion played a central role in determining CSR deployment: while some stakeholders regularly sent alternative responders on substance use calls, others described any mention of drugs -particularly methamphetamines-as automatically triggering police involvement. Barriers to effective CSR response included limited referral options for people who use drugs, fragmented service systems, community tensions around visible drug use, and perceived safety concerns. Facilitators included CSR teams' unique engagement capacity and potential for peer specialist involvement. To promote effectiveness of CSR as a public health intervention to reduce morbidity and mortality, programs must address discretionary decision-making, enhance training on stigma and harm reduction principles, and coordinate with broader service systems to ensure equitable access to non-police responses for people who use drugs.

The purpose of this study was to determine factors related to successful completion of peer support specialist training and certification. This study analyzed enrollment data to study graduation outcomes in 1,164 participants in the Certified Recovery Support Specialist (CRSS) Success Program, an intervention designed to scale up the number of peer specialists in the state by funding tuition and direct supports for students. Exploratory institutional-level binomial regression and grant funding data was used to understand the relationship between funding and graduation rate. Post-graduation survey data from 171 participants was also analyzed with logistic regression to understand factors associated with attempting and passing the peer specialist certification exam. Receiving financial support beyond tuition and receiving academic accommodations were strongly associated with an increased likelihood of graduation, while requiring service supports like counseling or legal assistance decreased this likelihood. Working as a peer specialist during training also significantly boosted the probability of graduation, whereas taking a leave of absence did the opposite. Among graduates, receiving tangible support during their training and having a smaller gap between graduation and attempting the exam were associated with attempting and passing the exam, respectively. Direct supports for students are associated with successful progression through the peer specialist training pipeline. Workforce development programs like the CRSS Success Program can further optimize outcomes by providing additional supports, especially to students at-risk of attrition.

Tobacco treatment has been a Veterans Health Administration (VHA) priority since 2008, which has increased access to treatment. However, additional system-level efforts are needed to reduce the disparities in smoking rates and tobacco treatment access that have persisted between veterans with and without serious mental illness (SMI). The local Institutional Review Board deemed this project exempt because of minimal risk to human subjects. We interviewed 20 VHA providers (psychiatrists, nurse practitioners, pharmacists, physicians, social workers, nurses, psychologists, peer specialists, and occupational therapists) from a local VHA health care system's outpatient SMI clinics and analyzed qualitative data using a rapid analysis inductive-deductive approach to determine how system-level barriers, such as administrative factors and social norms, influenced tobacco treatment delivery. Providers often tried to stay current on VHA tobacco treatment resources, but said that too much or too little information would stymie efforts. For example, high volumes of information sent via email and available on the intranet made it challenging to find smoking-related resources, while restricted information about changes to medication availability complicated prescribing. Providers described these barriers as interfering with their delivery of smoking treatment. Some also viewed tobacco discussions as antithetical to their mission of providing veteran-centered care, which dissuaded them from initiating such discussions. In addition, providers working in rural settings questioned the accessibility of certain VHA smoking cessation resources, like in-person groups or the VA Quit Line, for veterans with SMI. Finally, nonprescribers shared that the ease of coordinating care with prescribers facilitated tobacco treatment delivery. Mental health providers in a VHA health care system had difficulty accessing VHA tobacco treatment resources. Adjustments to medical record and electronic communication infrastructure, as well as more consistent communication between facility-level tobacco champions and frontline providers could make tobacco treatment resources more accessible to providers, though care is needed to ensure this information does not exacerbate information overload. Training and education that helps providers feel comfortable integrating tobacco treatment into routine mental health care is also critical to ensuring equitable access to tobacco treatment for veterans with SMI in rural areas.

This study examined the scope and functioning of peer recovery services across different roles and peer recovery programs. Specific aims included (a) considering the defining role of peer recovery specialists, (b) understanding how peer specialists achieve goals, (c) determining short- and long-term outcomes resulting from peer recovery services, and (d) identifying barriers and facilitators to service provision. A multimethod survey distributed via Qualtrics was used to collect responses from 108 peer recovery specialists, supervisory staff, and individuals receiving services across 23 programs. Qualitative responses were coded using an inductive coding strategy, whereas quantitative questions were analyzed using descriptive statistics and between-role comparisons. Participants endorsed lived experience and support as the primary roles of the peer recovery specialist, which facilitated connection to care and higher quality relationships. Several short-term outcomes were consistently endorsed across roles, including engagement in recovery services, social support, and crisis stabilization. Long-term outcomes were more variable. Peer specialists expressed challenges with maintaining boundaries with individuals given their personal experience and professional identities. Findings point to a shared understanding of the role of the peer recovery specialist and consistency in short-term outcomes across programs, both of which support the feasibility of establishing shared implementation (process) and outcome measures to guide evaluation efforts of peer recovery programs. We provide a short form, the Peer Recovery Services Checklist, to facilitate this goal. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Most rural Veterans with behavioral health concerns are not engaged in behavioral health care. Peer Support for Treatment Seeking (PS-TS) engages Veterans in care by leveraging Veteran peer specialists' unique skills to connect with other Veterans. PS-TS is a brief conversation about treatment-seeking beliefs that aims to connect Veterans to care. PS-TS was implemented in two rural Veterans Health Administration (VHA) regions in 2024. Evidence-based implementation strategies were used to support uptake of PS-TS, including working with local stakeholders to identify site-specific implementation barriers, tailoring implementation materials for peer-delivery, tracking adaptations, and training peers to deliver PS-TS. We evaluated impact using the RE-AIM domains of reach, effectiveness, adoption, implementation, and maintenance. Tailoring PS-TS and the implementation plan to fit the peers' scope of practice and the needs of rural Veterans enabled implementation, while peer discomfort with outreach calls and the complexity of delivering PS-TS were barriers. PS-TS content and training were adapted to provide peers with more support. Peers conducted 364 outreach calls and delivered PS-TS to 117 Veterans, of whom 43 (37%) initiated VHA behavioral health care and 17 (15%) sought community/other care. PS-TS fidelity was high overall, but quality of delivery was low moderate for more challenging components. PS-TS was not maintained after implementation support ended. Evidence-based implementation strategies enabled PS-TS to reach many rural Veterans with unmet behavioral health needs and increase care engagement. Future implementation efforts should prioritize increasing the quality of PS-TS delivery and enabling PS-TS maintenance over time.

Purpose Evidence indicates mental health staff need education when working with autistic people (Maddox et al, 2020; Crane et al, 2018). This project aims to address this through collaboration with a peer specialist (PS). Design/methodology/approach A service improvement case study to enhance community mental health team (CMHT) staff’s knowledge and skills when working with autistic adults with coexisting mental illnesses. Education sessions were co-created and co-delivered by a trainee advanced clinical practitioner (tACP) and an autistic PS (Crane et al, 2019, National Autistic Society, 2025). Data was collected using a cross-sectional survey. Both the tACP and PS provide reflections on co-production. Findings All participants reported improved knowledge of autism, with 6 of 7 agreeing their confidence working with autistic people with co-occurring mental illnesses had improved. All agreed that PS inclusion in training was valuable. Originality/value Despite small sample size, this project demonstrates clear need for autism training in CMHTs and supports PS inclusion in professional training. It examines co-production experience and benefits through reflections from both professional and PS perspectives.

On Being Helped by Helping: A Peer Specialist's Journey and the Science of Altruism in Recovery.

This mixed-methods study evaluated a pilot peer specialist intervention designed to reduce suicide risk in high-risk veterans with severe psychiatric disabilities. Veterans with high-risk flags for suicide (n = 12) were recruited, and peer specialists (PSs, n = 5) were trained for a feasibility study of peers for valued living, a 3-month semistructured suicide prevention intervention delivered by PSs. The Reliable Change Index was used to calculate whether veterans achieved reliable changes on standardized baseline-to-posttest assessments of personal recovery, depression, suicide ideation, perceived burden and thwarted belongingness, suicide cognitions, and hopefulness. Qualitative interviews with veterans as well as PSs and their supervisors were analyzed using rapid qualitative analysis. Most veterans (n = 10, 83.3%) improved on at least one measure, and five veterans (41.7%) deteriorated in at least one area. Reliable improvements were most common in suicide cognitions (n = 5, 41.7%) and suicidal ideation (n = 4, 33.3%). Qualitative analyses indicated that veterans uniformly described positive experiences with peers for valued living. PSs and supervisors were initially uneasy about openly discussing suicide and struggled to adopt the semistructured discussion framework. But with time, they felt more confident and skilled in engaging with high-risk veterans. This mixed-methods pilot study establishes the feasibility and preliminary effects of a peer-delivered suicide prevention intervention with veterans with high-risk flags for suicide. Reliable positive changes were observed in suicidal ideation and other suicide cognitions. Qualitative interviews identified a range of important factors that are critical to efforts to employ PSs more directly in suicide prevention roles. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Individuals with lived experience of mental health conditions provide a unique perspective to mental health services. In this systematic review, a broad definition of 'involvement in mental health services' was used, which included peer support, peer mentors, and peer specialists. This review aimed to explore the barriers and facilitators reported to peer involvement in mental health services, to develop an understanding of the impact on the 'peer' and mental health care. Five bibliographic databases were systematically searched (inception to May 2024) for qualitative studies, to identify the barriers and facilitators of peer involvement in mental health services. Data were analysed using the COM-B (capabilities, opportunities, motivation, and behaviour) model and Theoretical Domains Framework (TDF) to provide a theoretical framework for understanding the behaviour of being involved in mental health services. The thirty-three studies included in this review provided data across all components of the COM-B model and eleven of the TDF domains. Barriers included the wider staff teams' lack of knowledge about the peer role, which impacted the peers' capability to be involved. The conflict between the professional peer role and identity impacted peers' motivation, positively and negatively, to remain involved. A lack of social support led to peers feeling stigmatised and excluded from the wider team. When peers felt supported, they could use their skills and lived experience knowledge to drive change in the system. This review provides insight into the barriers and facilitating factors experienced by individuals in peer involvement roles within mental health services. The wider implications challenge the notion that peer involvement reduces stigma and discrimination. This review highlights that peer involvement can sometimes increase peers' experience of stigmatisation, specifically when involved in mental health services.

This study examined the workplace experiences of young adult peer support workers (YPSWs), including how these experiences differ by certification status and what barriers and recommendations YPSWs identify for improving their work environments.A cross-sectional survey was conducted via REDCap with 49 YPSWs aged 18-30 currently employed in a paid peer support role in the United States. Participants completed quantitative items assessing satisfaction with various workplace aspects, supervision, intergenerational inclusiveness, and stigma, and open-ended questions about workplace barriers and recommendations. Analyses included descriptive statistics, one-way ANOVA tests comparing certified and non-certified YPSWs, and thematic analysis of qualitative responses.Respondents reported relatively high satisfaction with fringe benefits, training, and supervision, but lower satisfaction with opportunities and rewards. Most reported a positive intergenerational climate and little stigma from coworkers. Youth certified peer specialists reported significantly lower satisfaction with opportunities and rewards and benefits than non-certified peers, and significantly lower satisfaction with supervision than general certified peer specialists. Qualitative data revealed key workload, policy, and individual barriers as well as age-related issues (e.g., lack of respect, imposter syndrome). Respondents recommended improvements for leadership, policy, job incentives, workforce capacity and support, peer integration, and collaboration and inclusion.Findings highlight both strengths and challenges in YPSW work environments, with notable disparities by certification status. Given their unique developmental stage and experiences of marginalization, strengthening this workforce will require attention to compensation, role clarity, and inclusion through a positive youth development lens.

Background Recovery homes often serve individuals who have co-occurring mental health and substance use recovery needs. In homes with peer staff (e.g. house managers), these staff are often the first to intervene in residents’ mental health concerns. As in other peer roles, residents’ mental health concerns may contribute to role drift – where a staff member begins to act outside their scope of expertise. Methods We conducted in-depth interviews with recovery residence staff (n = 45) at Level II and III recovery homes, including house operators, house managers, and recovery support peer specialists. Interviews explored the strategies these individuals use to avoid role drift when helping residents manage mental health concerns. Results Recovery residence staff reported two overarching strategies to combat role drift. First, recovery homes screened potential residents to ensure the applicants’ needs matched the intensity of services provided in the home. Individuals who needed more support or who exhibited psychological distress while living in the home were connected to appropriate local resources. Second, staff worked to establish clear expectations and boundaries about the types of support they could offer. Staff identified factors that exacerbated role drift, including gaps in available mental health services and cohabiting with the residents they serve. Conclusion Similar to many peer-to-peer roles, recovery housing staff often experience situations that create the potential for role drift. Organizational processes and adherence to peer support ethics can help staff manage these pressures in ways that protect themselves and the residents they serve.

Veterans with serious mental illness (SMI) experience a higher prevalence of obesity than the general veteran population; weight loss programs are needed that are tailored to this population. To evaluate a weight loss program, CoachToFit (CTF), which includes weekly calls from a Veteran Health Administration peer specialist, a Bluetooth-enabled scale and fitness tracker, and a smartphone application that provides health education and tracks steps, goals, and weight. This randomized clinical trial was conducted within the Pittsburgh Veteran Affairs health care system and presents pre-post (6 months) analysis comparing CTF and usual care. Veterans with body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 30 or higher and diagnosis of major depressive disorder, bipolar disorder, or schizophrenia were eligible for inclusion. Exclusion criteria included history of bariatric surgery or recent psychiatric hospitalization. The study was conducted from October 1, 2020, to September 30, 2025, and data analysis was conducted from January to October 2025. Random assignment to CTF. The primary outcomes were weight (in kg), BMI, and cardiorespiratory fitness (meters walked in 6 minutes). Among the sample (n = 256), mean (SD) age was 53.5 (13.1) years, 80 participants (31.3%) were female, and 199 (77.7%) were diagnosed with major depressive disorder. Mean (SD) weight loss at 6 months was -3.2 (6.2) kg in the CTF group (n = 128) compared to -1.6 (4.9) kg in the usual care group (P = .05). After adjustment, participants in CTF experienced greater, nonsignificant weight loss compared to usual care, with an adjusted mean difference (AMD) of -1.62 kg (95% CI, -3.38 to 0.14; P = .07). For BMI, the AMD in change between groups at 6 months was -0.56 (95% CI, -1.15 to 0.03; P = .06). Change in meters walked was not statistically significant between groups, with an AMD of 3.53 m (95% CI, -12.87 to 19.92; P = .67). At 6 months, 34 participants (36.6%) from the CTF group lost 5% or more of their body weight compared to 19 (22.4%) in usual care, representing a 1.93-fold greater likelihood in adjusted analyses (95% CI, 0.96-3.91; P = .07). More participants in CTF (n = 21 [22.6%]) lost 7% or more of their body weight compared to usual care (n = 7 [8.2%]), representing a 3.9-fold greater likelihood in adjusted analyses (95% CI, 1.45-10.36; P = .007). In this randomized clinical trial, a weight loss program tailored to veterans with SMI using remote technologies and paraprofessionals demonstrated the potential to help this population lose weight. ClinicalTrials.gov Identifier: NCT04560335.

Culturally responsive peer support services can improve access to and engagement with substance use and mental health services among Latinx persons, but how to implement a culturally responsive peer support program in a Spanish-speaking peer-run behavioral health organization is unclear. This qualitative study used the Consolidated Framework for Implementation Research (CFIR) to explore determinants for implementing a culturally responsive peer support program. We conducted 14 interviews with peer support program leadership, Certified Peer Specialists (CPS), and CPS supervisors about implementation of and experience with the peer support program. Interviews were conducted and analyzed in Spanish and English using constant comparative methods and organized according to the CFIR. Key CFIR elements included: (1) Intervention characteristics: a culturally responsive approach that alleviated stigma while celebrating recovery culture and Latinx peer culture; (2) Outer setting: outside of the study setting, barriers to accessing behavioral health care were driven by cultural differences between providers and clients; (3) Inner setting: A robust model of culturally responsive and linguistically appropriate peer-to-peer supervision and a built environment that fosters a mutual aid-oriented organizational culture; (4) Individuals involved: supervision strengthens CPS knowledge and skills to deliver peer support; (5) Implementation Process: despite organizational supports, CPS work is emotionally draining. Future studies should explore the scalability of the supervision model and other implementation supports described here, using a culturally responsive lens.

We assessed the impact of the COVID-19 pandemic on the implementation of a peer-integrated enhancement of integrated clinical care intervention to address the mental health needs of 450 patients undergoing treatment for a physical injury. Qualitative data were collected by 7 clinician investigators of a randomized controlled trial acting as participant observers in a trauma care setting of a major U.S. metropolitan hospital and analyzed in collaboration with an external mixed methods specialist. The pandemic created or exacerbated several implementation barriers, including increased risk of infection, homelessness, hospitalizations and comorbid conditions such as fentanyl overdoses that increased demand on emergency department and Trauma Center services, imposition of safety measures to reduce risk of infection in clinical settings, transition from face-to-face to virtual interactions with study patients, shortages of specialty mental health providers, suspension of recruitment of patients into the study, scheduling calls with patients, and an increased workload for the study clinical interventionists. Peer specialists perceived the transition to virtual interactions with patients reduced their effectiveness; however, this was not reflected in assessments of patient satisfaction with services received and may have inadvertently increased adoption by Trauma Center staff. Reduction in reach of the intervention to target population was temporary. The COVID-19 pandemic exacerbated existing barriers and created new barriers to successfully implementing evidence-based practices in trauma care settings, resulting in an attenuation of their effectiveness. However, the shift from face-to-face to virtual services delivery may have actually led to improved implementation outcomes. ClinicalTrials.gov identifier: NCT03569878. Registered June 15, 2018.

Reasons to Study the Impact of Peer Specialists as Teachers to Mental Health Staff.

Traditional mental health acute inpatient treatment has been described as harmful and traumatic. Peer-led community-based treatment is a new alternative model of care in New Zealand, whereby acute mental health treatment is provided in a home-like environment delivered by peer specialists with lived experience. A mixed-methods process evaluation compared socio-demographic and admission data from a peer-led acute service with those of a local public acute mental health hospital. Qualitative interviews were also conducted with guests (n = 10), peer specialists (n = 3), and clinical staff (n = 10), and analysed using inductive thematic analysis. The most common diagnoses of guests were major depressive disorder (28.7%) and psychotic disorder (20.6%). Compared with the traditional hospital, the peer-led service admitted fewer Indigenous Māori guests (14.8% vs. 18.9%), more women (64.6% vs. 44.7%), and fewer people from socioeconomically deprived areas. Risk was qualitatively identified as the main factor impacting referral patterns. Very few adverse events were recorded. Guests described positive experiences of interpersonal and environmental safety. Clinician and peer interviews highlighted issues with the alliance between the service and clinical outpatient teams. This evaluation indicated that peer-led acute community mental health services can foster recovery by offering safe, calm, and relationally supportive environments. However, the demographic profile of guests, often women from less deprived backgrounds, indicates the model may inadequately serve high-need groups. Future challenges include adopting a greater tolerance for risk through clear articulation of the services interpersonal and environmental safety approaches, enhancing equitable access, and improving clinicians' knowledge of recovery-oriented and peer-led treatment philosophies.

Brief mindfulness training can help veterans with posttraumatic stress disorder (PTSD) learn essential skills to manage distressing emotions and thoughts. This study sought to (a) refine the content of Primary Care Brief Mindfulness Training (PCBMT) to address PTSD symptoms and recovery, (b) improve the feasibility of training Veterans Health Administration staff to facilitate mindfulness classes, and (c) increase veteran attendance in the mindfulness classes by incorporating veteran peer specialists as PCBMT facilitators. The formative evaluation guided by the Framework for Reporting Adaptations and Modifications-Expanded included 32 mental health providers and five peer specialists who first participated in PCBMT and then provided suggestions for refinement. Qualitative responses were analyzed via rapid assessment and applied to refine PCBMT content. Next, facilitator training was delivered to providers and peers. Then, newly trained facilitators delivered PCBMT to veterans. Facilitator fidelity, veteran class attendance, satisfaction, and PTSD symptom change were assessed as adaptation outcomes. Content modifications included simplification of yoga poses, emphasis on trauma-sensitive content, and discussion of mindfulness in social situations. Training modifications included the development of a 3-day facilitator training. Context modifications incorporated role modeling and values clarification specifically for peer facilitators. Adapted PCBMT was associated with high facilitator fidelity, veteran attendance, and satisfaction and reduced PTSD symptoms (Cohen's d effect size = 0.79). (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Given well-established efficacy of contingency management (CM), demand grows for effective implementation support. Coaching-to-criterion is a strategy for assuring workforce capability to deliver CM programming with fidelity. To what extent this preparative strategy is comparably useful for addiction professionals and peer specialists is unknown. Two ongoing endeavors-state opioid response-funded implementation support for 7 sites implementing CM programming and an National Institute of Health-funded hybrid type 1 effectiveness/implementation trial testing peer-delivered CM at 9 sites-share a coaching-to-criterion process as common methodology. For workforce members, participation in serial group coaching sessions eventuated in completion of an observed standardized patient encounter with Likert-rating of 6 CM Competence Scale domains (1 = very poor, 7 = excellent). A coach provides immediate, performance-based feedback, and if an a priori benchmark ("adequate" ratings of 4) is not initially reached, a skill-specific replay opportunity is undertaken. Non-inferiority analysis tested scale score equivalence of addiction professionals (n = 51) and peer specialists (n = 64), relative to a 0.25 standard deviation (SD) margin. Comparative resourcing of coaching efforts, scale psychometrics, and patterns of CM skillfulness were also examined. As intended, all workforce members (N = 115) met the criterion, and the mean scale score (M = 29.74, SD = 3.67) exceeded the benchmark by +1.56 SDs. Independent-samples t-test confirmed absence of between-group difference, with effect magnitude (Cohen's d = 0.13) well within the non-inferiority margin. Similar resourcing of coaching efforts was evident, with a majority (61%-66%) of addiction professionals and peer specialists achieving the criterion on initial attempt. Psychometric analyses confirmed robust item-scale correlations (r = 0.58-0.66), and no consistent pattern was found in domain-specific skills. As demand grows for CM implementation, so too will the diversity of workforce needed to capably deliver it. This report documents that a coaching-to-criterion process sufficiently prepared both addiction professionals and peer specialists to deliver CM and that resulting skill among these groups did not appreciably differ nor did the required coaching efforts.

Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice. Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts. A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction. CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

IntroductionThe ACT team consists of mental health professionals with a wide range of expertise, including psychiatrists, psychologists, nurses, social workers, and peer specialists. The goal of ACT is to help patients achieve and maintain stability in the community, and to reduce the need for hospitalization and other forms of institutional care and reduce the barriers to care by bringing the care to the Patient.Upon discharge from the Psychiatric Hospital Patients are often sent home with more than one antipsychotic oral medication and are at times on two long-acting intramuscular preparations.This is an example of polypharmacy which refers to the concurrent use of multiple medications to treat a single patient, polypharmacy is often used to manage patients with complex mental health conditions who may require multiple medications to address their symptoms.ObjectivesThe AIM of the study is to determine the number of patients followed by the ACT team in the Bronx who are on 2 or more antipsychotics as compared to those on monotherapy who were re-hospitalized within 1 year of discharge.MethodsThis is a retrospective study on patients who are followed by Bronx ACT team affiliated with the Institute for Community Living (ICL) in NYC from February 2022 to February 2023. The study compared the number of re- hospitalizations of patients on 2 or more Antipsychotics as compared to those on Monotherapy from February 2022-February 2023. were a thorough review of charts of the 68 Clients being followed by the ACT team was done.ResultsOut of 68 patients being followed by the ACT team; 9 Patients were on 2 antipsychotics/ LAI (Long Acting Injectable) of which 5 patients were on 2 oral antipsychotics, 1 Patient on 3 oral antipsychotics, and 3 Patients on two long-acting intramuscular depot preparations of which five 5(3 for psychiatric related issues and 2 for medical reasons) out of 9 (55.55%) of this population were hospitalized in the 12-month reporting period of February 2022 to February 2023. As compared to 27 (45.7%) patients on monotherapy who were also hospitalized in the last 12-month reporting period.All remaining 32 (54.2%) clients on monotherapy had no hospitalizations in the 12 months reporting period.ConclusionsPatients who warrant the need to be followed by The ACT are majorly those who require intensive follow-up in the community and are mostly non-adherent with their medications and prescribing multiple antipsychotics that usually not taken should be carefully considered.Due to the nature of the study no definite conclusion could be drawn regarding causality between APP and hospitalizations within the 12-month reporting period.Disclosure of InterestNone Declared