title: Implementing Coordinated Specialty Care for Early Psychosis: The RAISE Connection Program.
abstract: OBJECTIVE
  The RAISE (Recovery After an Initial Schizophrenia Episode) Connection Program Implementation and Evaluation Study developed tools necessary to implement and disseminate an innovative team-based intervention designed to promote engagement and treatment participation, foster recovery, and minimize disability among individuals experiencing early psychosis. This article describes the treatment model and reports on service utilization and outcomes. It was hypothesized that individuals' symptoms and functioning would improve over time.
  
  
  METHODS
  A total of 65 individuals in RAISE Connection Program treatment across two sites (Baltimore and New York City) were enrolled and received services for up to two years. Primary outcomes, including social and occupational functioning and symptoms, were evaluated. Trajectories for individuals' outcomes over time were examined with linear and quadratic mixed-effects models with repeated measures.
  
  
  RESULTS
  Measures of occupational and social functioning improved significantly over time, symptoms declined, and rates of remission improved. Visits were most frequent during the first three months, with a mean±SD of 23.2±11.5 unduplicated staff encounters per quarter. Such encounters decreased to 8.8±5.2 in the final quarter of year 2.
  
  
  CONCLUSIONS
  The overall project was successful in that the treatment program was delivered and tools useful to other clinical settings were produced. The strengths of this study lie in the demonstrated feasibility of delivering the coordinated specialty care model and the associated high rates of engagement among individuals who are typically difficult to engage in treatment. Notwithstanding the lack of a built-in comparison group, participant outcomes were promising, with improvements comparable to those seen with other successful interventions.
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Dixon
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Goldman
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Melanie E
authors.initials: ME
authors.lastname: Bennett
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Yuanjia
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Karen A
authors.initials: KA
authors.lastname: McNamara
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Sapna J
authors.initials: SJ
authors.lastname: Mendon
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Goldstein
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Chien-Wen J
authors.initials: CW
authors.lastname: Choi
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Rufina J
authors.initials: RJ
authors.lastname: Lee
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Lieberman
authors.affiliation: Dr. Dixon, Ms. Mendon, Ms. Choi, Dr. Lieberman, and Dr. Essock are with the New York State Psychiatric Institute, New York City (e-mail: dixonli@nyspi.columbia.edu ). Dr. Dixon, Dr. Lieberman, and Dr. Essock are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons. Dr. Goldman, Dr. Bennett, and Dr. McNamara are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Wang is with the Division of Biostatistics, Mailman School of Public Health, Columbia University, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Lee is with the Silberman School of Social Work, Hunter College, City University of New York, New York City. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Essock
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore; D003657:Decision Making; D061345:Early Medical Intervention; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009519:New York City; D010358:Patient Participation; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012917:Social Adjustment; D055815:Young Adult