Implementing Coordinated Specialty Care for First Episode Psychosis: A Review of Barriers and Solutions

• Published in: Community mental health journal Vol. 57; no. 2; pp. 268 - 276
• Main Authors: Powell, Anna-Leigh, Hinger, Cassandra, Marshall-Lee, Erica D., Miller-Roberts, Tonya, Phillips, Kayla
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2021; Springer Nature B.V
• Subjects: Barriers; Clinical outcomes; Community and Environmental Psychology; Cultural competence; Disengagement; Early intervention; Literature reviews; Measurement; Medicine; Medicine & Public Health; Mental disorders; Original Paper; Professional development; Psychiatry; Psychosis; Rural areas; Rural communities; Rural development; Stigma; Teams; Treatment outcomes; Workforce; First episode psychosis; Literature review; Coordinated specialty care; Barriers to treatment; Specialized early interventions
• ISSN: 0010-3853; 1573-2789; 1573-2789
• DOI: 10.1007/s10597-020-00644-1

Specialized early interventions (SEI) for individuals diagnosed with a first episode of psychosis (FEP) are effective treatment modalities (Azrin et al. in Psychiatr Ann 45(11):548, https://doi.org/10.3928/00485713-20151103-05 , 2015 ). SEI offered immediately or shortly following a first episode improves functional and clinical outcomes for those individuals with, and at risk for, serious mental illness (SMI; Correll et al. in JAMA Psychiatry 75(6):555–565, https://doi.org/10.1001/jamapsychiatry.2018.0623 , 2018 ). In the United States, SEI programs referred to as Coordinated Specialty Care (CSC), have been utilized to provide a beneficial, team-based, multi-component method of treating FEP. However, despite the success, CSC programming is still met with considerable challenges. This article reviews existing CSC literature to identify and explore relevant barriers to successful implementation of CSC. Identified barriers include stigma, cultural competence, disengagement, measurement and evaluation, workforce development, implementation in rural areas, and financial stability. The ongoing efforts to address these barriers are described and areas for continued improvements are discussed.