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Columns   |    
Economic Grand Rounds: Financing First-Episode Psychosis Services in the United States
Howard H. Goldman, M.D., Ph.D.; Mustafa Karakus, Ph.D.; William Frey, Ph.D.; Kirsten Beronio, J.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201300106
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Dr. Goldman, who is editor of Psychiatric Services, is affiliated with the Department of Psychiatry, University of Maryland School of Medicine, 1501 South Edgewood St., Suite L, Baltimore, MD 21227 (e-mail: hh.goldman@verizon.net). Dr. Karakus and Dr. Frey are with Westat, Rockville, Maryland Ms. Beronio is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.

Copyright © 2013 by the American Psychiatric Association

Abstract

Adequate financing is essential to implementing services for individuals experiencing a first episode of a psychotic illness. Recovery After an Initial Schizophrenia Episode (RAISE), a project sponsored by the National Institute of Mental Health, is providing a practical test of the implementation and effectiveness of first-episode services in real-world settings. This column describes approaches to financing early intervention services that are being used at five of 18 U.S. sites participating in a clinical trial of a team-based, multielement RAISE intervention. The authors also describe new options for financing that will become available as the Affordable Care Act (ACA) is implemented more fully. The ACA will rationalize coverage of first-episode services, but the all-important Medicaid provisions will also require individual state action to implement services optimally.

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References

Addington  J:  The promise of early intervention.  Early Intervention in Psychiatry 1:294–307, 2007
[CrossRef] | [PubMed]
 
RAISE Early Treatment Program. Overview of Project. Bethesda, Md, National Institute of Mental Health. Available at www.raiseetp.org
 
McCoy  M;  Patton  L;  Goldman  H:  Developing a Framework for Identifying Opportunities for Earlier Intervention With People With Mental Illnesses . Prepared for the Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services.  Rockville, Md,  Westat, 2010
 
Patton  L;  Ratner  J;  Salkever  D:  Identifying Opportunities for Earlier Intervention for People With Mental Illnesses: Evaluation of the Financing Mechanisms of the Connection and the NAVIGATE Programs .  Rockville, Md,  Westat, 2010
 
Karakus  M;  Frey  W;  Goldman  H  et al:  Federal Financing of Supported Employment and Customized Employment for People With Mental Illnesses . Prepared for the Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services.  Rockville, Md,  Westat, 2011
 
Goldman  H;  Karakus  M;  Frey  W: Early Intervention Financing and Resources: Final Report. Prepared for the Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services.  Rockville, Md,  Westat, 2012. Available at aspe.hhs.gov/daltcp/reports/2012/EarlyInt.shtml
 
Goldman  HH:  Will health insurance reform in the United States help people with schizophrenia? Schizophrenia Bulletin 36:893–894, 2010
[CrossRef] | [PubMed]
 
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