Much attention has been paid lately to early and first episode psychosis. Youth and young adults with psychosis have typically waited long periods of time to be identified and provided services. That is all changing now because there is growing recognition that the longer psychosis goes untreated, the more serious it becomes. Early intervention is the key to far better long-term outcomes.
Early and First Episode Psychosis (FEP) programs were developed by clinicians and researchers who recognized the importance of early intervention and of providing an array of services that focus on recovery and allowing youth and young adults to keep their lives on track.
FEP programs use community outreach and a coordinated array of well-researched services and supports to identify youth and young adults early and to link them with help in school, in finding employment and maintaining connections with family, friends and community.
What services and supports are included in Early and FEP programs?
The coordinated array of recovery-oriented specialty care in FEP programs includes the following:
- Community Outreach – to youth, families, schools and others.
- Family support and education - providing an understanding of psychosis and how to achieve better outcomes.
- Peer support – connecting youth with all important peers.
- Supported education and employment – services and supports for youth.
- Case management.
- Cognitive behavioral therapy - addressing impairments in thinking, mood regulation and behavior.
- Low dose anti-psychotic medication.
The coordinated specialty care approach uses shared decision making and works with youth and young adults in partnership to reach their recovery goals.
What Early and FEP research initiatives currently exist?
There are a number of current research initiatives in the US on early and first episode psychosis.
The National Institute of Mental Health (NIMH) developed the Recovery After an Initial Schizophrenia Episode (RAISE) research project to study the use of coordinated specialty care in the US.
There were two RAISE research programs supported by NIMH:
- RAISE Early Treatment Program (ETP) – a multi-site program led by Dr. John Kane, Feinstein Institute for Medical Research. There are multiple ETP sites around the country; and
These studies are no longer recruiting individuals to participate.
Research on early psychosis has also been funded by The Robert Wood Johnson Foundation (RWJF). The RWJF Early Detection, Intervention and Prevention of Psychosis Program (EDIPP) funded study also examined outcomes achieved through assertive outreach and engagement and providing a comprehensive array of services and supports like those used in the RAISE program.
Why is this important?
Early research shows tremendous promise in lessening the long-term severity of psychosis. Researchers and program developers also recognize the key role that family support and education and peer support play in delivering recovery-focused services and supports.
There are tremendous opportunities for NAMI to be involved in and to support this promising work.