Comprehensive Versus Usual Community Care for First Episode Psychosis: Two-Year Outcomes from the NIMH RAISE Early Treatment Program

Authors: John M. Kane, Delbert G. Robinson, Nina R. Schooler, Kim T. Mueser, David L. Penn, Robert A. Rosenheck, Jean Addington, Mary F. Brunette, Christoph U. Correll, Sue E. Estroff, Patricia Marcy, James Robinson, Piper S. Meyer-Kalos, Jennifer D. Gottlieb, Shirley M. Glynn, David W. Lynde, Ronny Pipes, Benji T. Kurian, Alexander L. Miller, Susan T. Azrin, Amy B. Goldstein, Joanne B. Severe, Haiqun Lin, Kyaw J. Sint, Manju John, Robert K. Heinssen

A comprehensive, multidisciplinary team-based treatment program for treating first episode psychosis improved participants’ quality of life and engagement in work and school.

Background

People with schizophrenia often experience poor health and social outcomes. Evidence shows that treatment initiated closer to onset of first psychosis, which is marked by symptoms such as delusions and hallucinations, can reduce the presence and adverse effects of symptoms. NAVIGATE is a first-episode psychosis treatment program that includes medication management, psychotherapy, family education, and support with education and employment. This randomized control study measured quality of life, symptom severity, and educational and vocational engagement of individuals in the two years following engagement in NAVIGATE versus those that received regular treatment managed by a provider.

Findings

Participating treatment clinics were randomly assigned to provide care under the NAVIGATE model or standard care, serving 404 individuals experiencing first-episode psychosis. Individuals in the NAVIGATE group remained in treatment longer, were more likely to be employed or in school, and scored higher in quality of life and symptom assessments compared to the control group, with stronger effects among those with shorter baseline duration of untreated psychosis.

Takeaways

This study demonstrated that coordinated care, such as NAVIGATE, can significantly improve longer term clinical and functional outcomes for individuals experiencing first-episode psychosis, including schizophrenia and related disorders. The findings reinforce the importance of scaling early identification and rapid treatment initiation to maximize benefits. This research was part of the Recovery After an Initial Schizophrenia Episode – Early Treatment Program (RAISE-ETP) initiative study, which aimed to develop and test innovative approaches to treat first episode psychosis that can be successfully implemented in community treatment settings across the United States.

Posted: May 2026