Two faculty members at the University of North Carolina at Chapel Hill played key roles in new research demonstrating that treating people with first episode psychosis using a team-based, coordinated specialty care approach produces better clinical and functional outcomes than typical community care. Investigators also found that treatment is most effective for people who receive care soon after psychotic symptoms begin.
David L. Penn, Linda Wagner-Martin Distinguished Professor in the Department of Psychology and Neuroscience in the College of Arts and Sciences, and Sue E. Estroff, a professor in the Department of Social Medicine, were both part of the executive team of the Recovery After an Initial Schizophrenia Episode (RAISE) project.
Penn and his former UNC research coordinator, Piper Meyer, led a group of researchers tasked with developing the individual therapy component of RAISE, which is known as Individual Resiliency Training or IRT. Estroff spearheaded a group that studied the issues related to stigma and service utilization.
Funded by the National Institute of Mental Health (NIMH), RAISE is a large-scale research initiative that began in 2008 (www.nimh.nih.gov/RAISE). It is comprised of two studies examining different aspects of coordinated specialty care treatments for people experiencing first episode psychosis.
The UNC-Chapel Hill team’s research is part of NAVIGATE, a nationally coordinated specialty care treatment program. The results of the NAVIGATE outcome study – the largest first episode treatment study ever conducted in the U.S., which included 404 participants in 34 clinics across 21 states – were published in the October issue of The American Journal of Psychiatry.
“This is why we do clinical research,” said Penn. “Not only did the participants in the study benefit from coordinated specialty care, but the results have already had an impact on mental health practice in the United States.
“The Substance Abuse and Mental Health Services Administration (SAMHSA) has provided state block grants to develop and expand coordinated specialty care to treat first episode psychosis, and this promises to revolutionize treatment for psychosis in this country,” said Penn, who also serves as the director of psychological services at the Outreach and Support Intervention Services (OASIS) program at the UNC Center for Excellence in Community Mental Health.
“The findings are particularly important because quality of life was our main outcome variable and that showed significant improvement,” said Estroff. “The intervention was focused on the daily lives and self-images of these younger people who are newly confronting schizophrenia, in addition to clinical treatment. Sense of self was as important as symptoms in the study design and for the participants.”
