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Recovery After an Initial Schizophrenia Episode (RAISE)

What was RAISE?

Launched in 2008, the Recovery After an Initial Schizophrenia Episode (RAISE) was a large-scale research initiative testing coordinated specialty care treatments. RAISE aimed to determine the best ways to help people recover from a psychotic episode and to reduce the likelihood of future episodes and long-term disability.

What is psychosis?

Psychosis refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During an episode of psychosis, a person’s thoughts and perceptions are disrupted, and they may have difficulty recognizing what is real and what is not.

What is coordinated specialty care?

Coordinated specialty care is a recovery-oriented, team approach to treating early psychosis that promotes easy access to care and shared decision-making among specialists, the person experiencing psychosis, and family members.

Specifically, coordinated specialty care involves multiple components:

  • Individual or group psychotherapy is tailored to a person’s recovery goals. Cognitive and behavioral therapy focuses on developing the knowledge and skills necessary to build resilience and cope with aspects of psychosis while maintaining and achieving personal goals.
  • Family support and education programs teach family members about psychosis as well as coping, communication, and problem-solving skills.
  • Medication management involves health care providers tailoring medication to a person’s specific needs by selecting the appropriate type and dose to help reduce psychosis symptoms.
  • Supported employment and education services aim to help individuals return to work or school, using the support of a coach to help people achieve their goals.
  • Case management allows people with psychosis to work with a case manager to address practical problems and improve access to needed support services.

Why was RAISE a priority for NIMH?

Left untreated psychotic symptoms can lead to disruptions in school and work, strained family relationships, and separation from friends. The longer symptoms go untreated, the greater the risk of a person developing a substance use disorder, injuring themselves, and becoming homeless or unemployed.

Studies have shown that people experiencing first-time psychosis in the United States typically have symptoms for more than a year before receiving treatment. It is important to reduce the length of time between the start of psychotic symptoms and the beginning of treatment because people tend to do better when they receive effective treatment as early as possible.

Early diagnosis and appropriate treatment make it possible to recover from psychosis. Some people who receive early treatment never have another psychotic episode. For other people, recovery means the ability to live a fulfilling and productive life, even if psychotic symptoms sometimes return.

What was the impact of RAISE?

Research from RAISE  demonstrated that coordinated specialty care was more effective than typical care. Individuals in RAISE studies who received coordinated specialty care stayed in treatment longer and experienced greater improvement in their symptoms, interpersonal relationships, and quality of life. These people were more involved in work and school than those who received typical care.

RAISE also showed  that it was possible to implement coordinated specialty care programs in real-world, community-based settings. 

Coordinated specialty care is now the standard of care for treating early psychosis, according to “The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia .” 

In 2019, based on RAISE findings and the growth of clinical programs using coordinated specialty care approaches, NIMH launched the Early Psychosis Intervention Network (EPINET). EPINET funded awards to establish regional scientific hubs connected to multiple coordinated specialty care programs that provide early psychosis treatment and a national data coordinating center. The initiative has expanded to eight regional hubs in 17 states with more than 100 clinics that provide coordinated specialty care.

Learn more about RAISE

Additional resources

Science news and research highlights

Last Reviewed: October 2022