Creating a collaborative culture of learning within a network of community mental health early psychosis programs in Texas

Learning Health Systems (LHSs) promise meaningful health care improvement through the ongoing use of data, including the lived experience of diverse constituents, such as people participating in and providing services. Most LHSs operate within a specific healthcare system, typically hospital-based, under a common electronic health record (EHR) and management structure. The Early Psychosis Intervention Network in Texas (EPINET-TX) is a novel case study of a developing LHS across 16 independent community mental health clinics operating statefunded coordinated specialty care (CSC) programs for early psychosis. EPINET-TX is a partnership among a multidisciplinary research hub and state and local entities. Grounded in participatory research frameworks, multiple strategies were utilized to align partners around learning goals, build data use competencies, enhance researchers' understanding of program context, and cultivate a continuous performance improvement mindset. Key strategies for developing a LHS culture included a) intentionally building collaborative relationships, b) establishing shared values and governance, c) collaborating in research and change-focused workgroups, and d) sharing learning and growth experiences. For CSC programs operating within the public mental health system, the LHS framework provides a promising model to foster quality improvement, innovation, and action-oriented participatory research.