WASHINGTON — Roughly two million Americans suffer from schizophrenia. Among them is a young woman from Maryland named Maggie.
“I was fifteen years old when my first episode happened,” she remembers. “I was actually sleeping over at a friend’s house and I woke up and — boom! — the voices were there.”
Maggie, who prefers not to give her last name, says it felt like someone flipped on a light switch. The voices suddenly appeared and never really went away.
“I was scared, very much scared at first,” she recalls, emphasizing that she really didn’t know what was going on. There was a hospitalization, and doses of nearly every antipsychotic drug in a pharmacy’s arsenal, including some usually considered to be a last resort.
Nothing really worked, until a psychiatrist got Maggie, who is now 20, into an experimental program under the auspices of the National Institute of Mental Health.
The program is called RAISE — Recovery After an Initial Schizophrenia Episode — and it offers what some consider to be a groundbreaking comprehensive approach to the treatment of schizophrenia.
Working largely with young adults, the RAISE program focuses on early intervention using fewer drugs and a greater reliance on talk therapy and various support services.
“We found that individuals who received that kind of treatment recovered faster in terms of their psychotic symptoms, depression, interpersonal functioning and return to school or work,” says Dr. Robert Heinsson, the NIMH study director.
Some would call it a holistic approach. Technically, it is known as “team-based coordinated specialty care.”
The first patients were recruited for the two-year program in 2010 — the year Maggie enrolled through a community health center near her home in the Baltimore area.
This time, the federal government went big with its research. Instead of farming it out to a few university labs, they chose 17 mental health centers in 17 different states, offering special training to staff on this new coordinated approach to mental illness.
NIMH chose these centers because they wanted to see how the program would work in a real community setting. The final person enrolled in the study completed treatment late last year.
The results were so good that Medicare and Medicaid endorsed this approach to treatment just days before the results were formally published in the American Journal of Psychiatry.
“We now know there is a better way of organizing care for young people who are at risk for serious mental illness and we are putting that knowledge into action rapidly,” says Heinssen.
All this comes as Congress considers mental health care reform, and advocates for the mentally ill say the timing couldn’t be better.
“In our complex delivery system, we all have to figure out how to make this model more of a standard of care,” says Dr. Ken Duckworth, a psychiatrist and medical director for the National Alliance on Mental Illness.
He says the RAISE study points to the importance of both early intervention and a comprehensive set of patient services, and offers proof that the combination can provide significant results.
“This actually demonstrates that this is not pie in the sky, this actually could be done,” says Duckworth.
Maggie, who had her first psychotic episode as a high schooler, offers living proof.
“The RAISE program definitely gave me hope that my life could be normal,” she says, noting with a smile and no small amount of pride that she is now in nursing school, and hopes to graduate in 2017.
