Q: What is RAISE?
A: RAISE is a large-scale, NIMH research project that seeks to fundamentally change the way schizophrenia is treated by developing and testing innovative and coordinated intervention approaches in the early stages of the illness when symptoms may be most responsive to treatment.
Q: Why is RAISE important?
A: Schizophrenia is a devastating mental illness. Symptoms that characterize the disorder, such as hallucinations and delusions, often derail normal academic and vocational progress and disrupt the development of social and interpersonal relationships that prepare a young person for adult roles and responsibilities. As the disease progresses, impairments caused by schizophrenia may cause a person to drop out of school, lose the ability to work, and become isolated from friends and family. Many people with schizophrenia experience periods of homelessness or incarceration, and some may develop substance abuse problems.
The RAISE project is designed to alter the long-term disability that can result from schizophrenia and help ensure that people with the disease can lead productive, independent lives. Preventing the disability associated with schizophrenia also has the potential to reduce the disease's impact on public systems, such as Social Security, law enforcement, state mental health services, and private organizations that serve those with mental illnesses.
Q: What suggests that early treatment can reduce long-term disability from schizophrenia?
A: Previous research suggests that the longer treatment is delayed after a first episode of psychosis, the less likely it is that the person will experience a significant degree of recovery. When left untreated, psychotic symptoms can lead to a host of subsequent problems, including disruptions in school and work, strained family relations, and estrangement from friends. The risk for co-occurring problems, such as substance abuse, incarceration, or homelessness, increases the longer initial symptoms persist. These changes in a person's life circumstances can make access to treatment, the likelihood of maintaining treatment, and the prospects of recovery much more difficult.
Q: How and why are other agencies and organizations involved in RAISE?
A: Agencies and organizations that play a role in providing health care and other services to people with schizophrenia will have an opportunity to participate in the design of the interventions to be evaluated by RAISE. Federal agencies including the Substance Abuse and Mental Health Services Administration, the Social Security Administration, the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, the Walter Reed Army Medical Center, and the National Institute on Drug Abuse, will be involved, along with mental health care consumers and family members, private health care providers, additional scientific experts, and state and local agencies. Other agencies may become involved as the project proceeds. Involving these agencies and groups will help ensure that, if successful, this evidence-based approach can be disseminated and adopted rapidly, thus significantly speeding the transition between research findings and their use in real-world practice.
Q: What types of treatments will be part of the RAISE interventions? How will they be different from conventional treatment?
A: The interventions will include the range of therapies and support currently available for schizophrenia, including medications, psychosocial therapies, rehabilitation services, and supported employment, all aimed at promoting symptom reduction and improving the ability to work, participate in social life, and live independently. While these individual approaches are available to some extent now, the goal of RAISE is to provide an integrated system of intervention, incorporating varied approaches in a systematic way, tailored to individuals, and achievable in the real-world environments in which people with schizophrenia obtain assistance.