Accelerating Science Psychosis
Accelerating Science Psychosis
Accelerating Science Psychosis
It takes approximately 17 years for research ndings to inuence clinical practice, and even longer for a scientic
discovery to have an impact on public health. Seventeen
years also falls within the lower bound of the age of onset for
schizophrenia, a devastating mental disorder characterized
by recurrent psychotic episodes and accumulating disability.
To improve outcomes for young adults with early psychosis,
NIMH launched the Recovery After an Initial Schizophrenia
Episode (RAISE) initiative in 2008. The goals were to develop a comprehensive, person-centered intervention for
rst-episode psychosis (FEP), test it in U.S. community treatment settings, and expedite dissemination, adoption, and implementation of promising ndings.
Rapid uptake of evidence-based interventions can occur
when clinical research purposefully bridges gaps between
service users needs, scientic curiosity, and policy makers
concerns. The RAISE funding announcement took this into
account and required investigators to establish partnerships
with principal stakeholdersthat is, service users, family
members, clinicians, and health care administratorsat
every stage of the research process. RAISE investigators
studied implementation processes alongside outcomes and
developed training and program materials to support the
establishment of coordinated specialty care (CSC) programs
in community clinics. The articles and columns in the special section suggest notable progress after only seven years
a decade earlier than the often cited 17 yearsbecause they
address implementation challenges and answer questions
about feasibility, accountability, acceptability, effectiveness,
and sustainability.
Is it feasible to implement CSC programs in routine settings?
Yes. The articles by Dixon and colleagues and by Mueser and
colleagues each describe team-based multicomponent programs for FEP. Across the two RAISE studies, 19 new CSC
programs were established by training community mental
health providers in stage-specic care for FEP.
Can treatment delity be monitored in a practical way?
Yes. The Best Practices column by Essock and colleagues
describes an approach to CSC delity monitoring that uses
information drawn from readily available data, such as
routine service logs. Practical approaches to delity monitoring may be cost-effective and can provide an ongoing data
source for quality improvement activities.
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