Reducing the Duration of Untreated Psychosis in the United States (R34 Clinical Trial Required)

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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 schizophrenia and related psychotic disorders. Compared to traditional treatment approaches, programs that integrate pharmacologic, psychological, and rehabilitation interventions for FEP, i.e., team-based Coordinated Specialty Care (CSC), have been found to produce a range of positive clinical and functional outcomes. However, the timing of treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. Unfortunately, numerous studies find a substantial delay between the onset of psychotic symptoms and the initiation of FEP care; in the U.S. treatment is typically delayed between one and three years. Early identification of FEP, rapid referral to evidence-based services, and effective engagement in CSC are essential to shortening the duration of untreated psychosis (DUP) and pre-empting the functional deterioration common in psychotic disorders. The World Health Organization advocates reducing DUP to 3 months or less. Accordingly, this Funding Opportunity Announcement (FOA) seeks planning grant applications that (1) identify a baseline rate of DUP in community settings that include CSC programs; (2) map referral pathways to CSC care, (3) identify bottlenecks and gaps in the pathway to CSC care, and (4) develop and pilot test feasible strategies for substantially reducing DUP among persons with FEP.

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