This op-ed was co-authored by Holly Doggett, Executive Director for National Alliance on Mental Illness Texas, and Dr. Octavio N. Martinez Jr., Executive Director for the Hogg Foundation for Mental Health. It was originally published by TribTalk (a publication of The Texas Tribune).
Given the opportunity to dramatically change the course of a young person’s life for the better, most people would pursue it. Unfortunately, many young people experiencing early episodes of psychosis in Texas aren’t able to access the treatment and care that could give them that opportunity. Going forward, the state of Texas has the opportunity to fill this gap for individuals, families and communities across the state.
Nationwide, about 100,000 young people experience psychosis each year. Psychosis is defined as a disruption in a person’s thoughts and perceptions that makes it difficult for them to realize what is real and what isn’t. For a young person who experiences psychosis related to schizophrenia, these changes come gradually, and are frightening and confusing. But research has shown that Coordinated Specialty Care (CSC), a team-based approach that encourages shared decision-making about treatment and recovery goals, can make a dramatic difference for these young people, helping them get their lives back on track. Also, of great importance, CSC treatment involves family members as much as possible.
Texas has 10 programs and 12 teams that now offer CSC treatment for youth and young adults experiencing psychosis related to schizophrenia. Beyond recovery-oriented therapy and medication management, CSC programs include case management, supported education and employment, peer and family support and education. Each component of the program is provided by a team of specially trained professionals who help individuals get back on track and realize their goals, like finishing school or returning to work.
Research shows that individuals with early psychosis who receive CSC (in comparison to traditional treatment) experience greater improvement in their symptoms, relationships, quality of life, work or school involvement and treatment engagement. It also shows that the sooner young people get treatment, the greater the improvements: symptom alleviation, employment linkages, social and family engagement, and a wide range of other positive indicators.
Unfortunately, the state’s 10 programs and 12 teams are not adequate to serve the population of youth and young adults who could benefit from CSC programs now and in the future throughout Texas.
Because early intervention and treatment are key to achieving the best outcomes for people experiencing their first episodes of psychosis, it is critical to expand these programs throughout the state. To do so, significant support is necessary to expand and sustain CSC programs.
Congress now supports these programs by requiring that 10 percent of the state’s Mental Health Block Grant funds be used to help expand CSC programs for early psychosis. That set-aside provides an initial investment for these programs, which can be supplemented by government and private funding.
The benefits of investment in CSC programs to treat early psychosis go beyond improving individuals’ quality of life — it can also help improve state and community budgets in the long run. Schizophrenia costs the U.S. economy an estimated $155.7 billion a year in direct health care costs, unemployment and lost productivity for caregivers. Crisis-driven care for people with serious mental illness, including schizophrenia, sadly leads to high rates of unemployment, school drop-out, homelessness, incarceration, suicide and early death.
Individuals who complete CSC programs have higher rates of school completion and of employment compared to their counterparts not participating in these programs. Although the cost of these programs is slightly higher than the traditional course of treatment, adequately funding CSC programs for early psychosis can produce better clinical and quality of life outcomes, making it a better value in the long term. At a time of uncertain revenue projections and tightening budgets, investing in supportive services and early intervention can help Texas reduce spending on costlier alternatives — in addition to the incredible benefit to young adults and their families.
Every young person deserves hope and recovery. To accomplish this, Texas must address funding for CSC programs and make them available in every corner of this great state. Texans do not turn their backs on others in need. Let’s invest in our future and give young adults the opportunity for recovery and hope for their future.