Reducing the Duration of Untreated Psychosis in the United States (R01)

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Approximately 100,000 adolescents and young adults in the United States experience a first episode of psychosis (FEP) every year. The early phase of psychotic illness is widely viewed as a critical opportunity for indicated prevention, and a chance to alter the downward trajectory and poor outcomes associated with serious mental disorders such as schizophrenia. Multi-element FEP specialty care programs can produce a range of positive clinical and functional outcomes. The timing of treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. Numerous studies find a substantial delay between the onset of psychotic symptoms and the initiation of treatment; in the U.S. treatment is typically delayed between one and three years, suggesting that many FEP persons are missing a critical opportunity to benefit from early intervention. Early identification, rapid referral to specialty FEP care, and engagement in phase-specific treatment are essential to shortening the duration of untreated psychosis (DUP) and pre-empting functional deterioration. The World Health Organization advocates reducing DUP to 3 months or less by addressing bottlenecks in the pathway from early psychosis identification to initiation of specialty care. Accordingly, this Funding Opportunity Announcement (FOA) with set-aside funds will support R01 grants that test reproducible strategies for substantially reducing DUP among persons with FEP by removing significant bottlenecks in the pathway to specialty FEP care.

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