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03-25 Early intervention for psychotic episodes saves lives

Early intervention for psychotic episodes saves lives

Most mental health clinicians are proponents of early intervention and for most mental disorders. The notion of preventing escalation and substance abuse by treating symptoms early has been widely shown to improve outcomes for many mental illnesses, including psychotic disorders.

Psychotic disorders cost billions of dollars in health care expenses each year, mainly due to emergency hospitalizations for psychotic episodes. Inadequate symptom management also affects the ability to study or work and increases the risk of suicide. The toll that psychosis takes on patients, families and society cannot be quantified. If early intervention helps minimize this toll, such programs need to be established.

A symptom for an underlying disorder

Psychosis is the symptom of an underlying problem, such as schizophrenia or bipolar disorder. Extreme conditions can also trigger psychosis, such as illness, drug use or trauma. The first episode usually occurs during adolescence or young adulthood.

According to the National Alliance on Mental Illness, some warning signs of psychosis can include the following:

  • A major drop in grades or job performance
  • Difficulty concentrating or thinking clearly
  • Suspiciousness of others
  • Poor self-care and hygiene
  • Spending more time alone
  • Inappropriate emotions or no feelings at all

The benefits of specialty care

In 2008, the National Institute of Mental Health launched a research initiative called “Recovery After an Initial Schizophrenia Episode (RAISE)” to develop an effective treatment approach for first episode psychosis (FEP). The program consisted of coordinated specialty care that offered psychotherapy, medication stabilization, family education and support, case management and vocational support.

So far, study reports have indicated that the RAISE programs for FEP patients appeared to be more effective than other forms of care, and that participants believed the program helped them. But the increased cost of these programs needed to be justified before such clinical programs could be funded.

This latest report published March 15, 2016 in Schizophrenia Bulletin Advanced Access describes the economic evaluation of RAISE programs for FEP patients. Investigators compared outcomes between patients who received coordinated specialty care with those who received usual community care. Patients in specialty care had better quality of life but higher medication costs. When quality of life was monetized and medication costs reassessed using generic prices, the benefits of the specialty care justified the cost.

Several specialized centers exist, like Sovereign Health, which provides specialized care similar to the RAISE program. Getting people into such programs early is crucial, ideally during their first episode of psychosis. If you or someone you love is experiencing symptoms of mental illness, remember that early intervention can be a life-saving step.

About us

Sovereign Health Rancho San Diego treats adolescents with mental illnesses, substance use disorders and co-occurring disorders. Our programs offer coordinated specialty care, including accurate diagnosis, psychotherapy, medication stabilization, case management, family education and support, integrated education and more. To find out more about specialized programs at Sovereign Health, please call our 24/7 helpline.

About the author

Dana Connolly, Ph.D., is a senior staff writer for the Sovereign Health Group, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. The Sovereign Health Group is a health information resource and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at

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