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Early Intervention in Psychosis: From Science to Services

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The Palgrave Handbook of American Mental Health Policy

Abstract

Early intervention services for psychotic disorders were first tested in Australia and Europe in the 1990s. These efforts stimulated interest to develop early intervention programs in the United States and in 2016 the National Institute of Mental Health identified a treatment model called Coordinated Specialty Care (CSC). This team-based approach includes psychotherapy, medication management, family education and support, case management, and work or education support, and is the foundation for nationwide efforts to support early intervention services for individuals with a first episode psychosis (FEP). This chapter focuses on the following key policy questions related to early intervention services for FEP and in particular the CSC model: What has been the impact of CSC programs? What strategies can most effectively support implementation of these programs? How should quality of care be assessed in CSC programs? and How can they be financially sustained? For each area, specific questions are posed, prior relevant studies are summarized, and future directions for research are proposed along with recommendations for policy makers. Other key issues reviewed include the importance of decreasing the duration of untreated psychosis, whether CSC programs should be offered to clinical high-risk populations before the advent of psychosis, and strategies for sustaining good outcomes following receipt of CSC services.

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Authors and Affiliations

  1. New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Thomas E. Smith & Lisa B. Dixon

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  1. Thomas E. Smith
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  2. Lisa B. Dixon
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  1. University of Maryland, School of Medicine, Baltimore, MD, USA

    Howard H. Goldman

  2. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    Richard G. Frank

  3. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Joseph P. Morrissey

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Smith, T.E., Dixon, L.B. (2020). Early Intervention in Psychosis: From Science to Services. In: Goldman, H., Frank, R., Morrissey, J. (eds) The Palgrave Handbook of American Mental Health Policy. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-11908-9_11

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