Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center

Abstract

Early intervention may improve long-term outcomes for psychotic illnesses.Early-intervention services in other countries have focused on reducing the duration of untreated illness and adapting interventions for younger patients.This column describes the process of building such a service, called specialized treatment early in psychosis (STEP), at the Connecticut Mental Health Center.This effort is rooted in a longstanding collaborative relationship between the Connecticut Department of Mental Health and Addiction Services and Yale.The authors describe the critical contribution of such partnerships in evaluating the cost-effectiveness of early intervention in a "real-world" U.S. setting.Psychotic disorders rank among the top ten causes of global disability (1).Health care policy in Australia, the United Kingdom, and Scandinavia (2) has included systematic efforts to implement, study, and refine early-intervention services.These are models of care that attempt to reduce the duration of untreated illness and provide care adapted to younger patients.Three randomized controlled trials of early-intervention programs have demonstrated modest reductions in symptom severity, relapse rates, and suicidality and improvements in social and vocational functioning and quality of life (3-5).