Inadequately treated schizophrenia is a life sentence.
The statistics and the stories are uniformly grim: Loss of family. Loss of home. Loss of friends. Loss of higher education, jobs, career-long productivity. Loss of physical health. Loss of lifespan.
Of the tens of thousands of Coloradans struck by the devastating mental illness, many will “end up homeless, in jail, or in prison,” as one Denver mental health leader put it.
But what if there were a proven regimen for early and intensive treatment of schizophrenia, tested nationally, and rigorously measured against a control group – a regimen with life-changing results?
Now there is. And hope comes with it, to a state that has been troubled by very public examples of schizophrenia as well as thousands of quieter cases that prove devastating in their own way.
An early-intervention treatment regimen called RAISE – Recovery After Initial Schizophrenia Episode – was developed nationally and control-tested successfully at dozens of sites, including the Mental Health Center of Denver. After following the study subjects for nearly four years each, the federally-sponsored experiment shows RAISE results in higher quality of life for those diagnosed with schizophrenia; fewer hospital stays and jail days, and improved physical health.
The formula relies on intensive case management that sends a professional into family homes and job sites; drug protocols with careful monitoring; job counseling; individual counseling and family education; substance abuse treatment, and other supports. Most importantly, the interventions begin within months of a first episode of psychosis.
The Mental Health Center of Denver and partners across the state are dedicated to helping people take back the parts of their lives that an illness has taken away from them. Colorado now has a unique opportunity to apply the RAISE model to all people from the moment they are touched by schizophrenia.
A federal bulletin in October cited the promising studies in urging that all states create new pathways for the intensive early treatment. And Colorado Medicaid officials are leading the way locally with a planning grant to help clinics create treatment teams and identify the funds to pay for them. The state will then pursue a broader implementation grant to spread the schizophrenia model far and wide.
It’s encouraging, and it’s also about time.
“The United States is really a decade behind the rest of the world in doing what we already know works,” Yale School of Medicine professor Vinod Srihari told The Washington Post, after encouraging results from RAISE.
Metro Denver residents, at least, can be thankful Colorado is not quite so far behind the rest of the world. The Mental Health Center of Denver has long modeled its treatment of an initial psychosis episode on the community-wide intervention theory.
The center has had in place transitional residential facilities to stabilize people while they receive therapy and drugs, while also relieving families of schizophrenia’s relationship-crushing burden. The people served at our clinic also had access to vocational counseling and substance abuse sessions. Still, the RAISE model ‘took it up a notch’ for the Mental Health Center of Denver. During the RAISE project, we added case management to our protocol to help the people we serve engage in and benefit from the overall treatment.
Of the 17 Denver-area youths screened and eventually included in the study protocols, many have made significant life changes that belie the hopelessness often associated with discussions of schizophrenia.
It’s important to let not just those we serve know, but also to let the community know, that this approach makes a difference. These are illnesses of young people, and it can affect their whole life. Now it’s up to the Colorado health community to bring RAISE to as many young lives as possible.
Cheryl Clark, MD, Vice President and Chief Medical/Chief Clinical Officer
Steve Fisher, LPC, Program Manager, Wellshire Behavioral Services