U.S Department of Health & Human Services (HHS)
March 2, 2018
Research shows that coordinated, early intervention can yield successful outcomes for people with mental illness.1 The Recovery After an Initial Schizophrenia Episode (RAISE) project is a large-scale initiative sponsored by NIMH and SAMHSA to test the effectiveness of coordinated specialty care for people experiencing their first psychotic episode. Coordinated specialty care (CSC) brings together a team of specialists who work with an individual to customize a treatment plan with psychotherapy, medication management, case management, family education and support, and work or school support.2 In one RAISE study, patients who entered a CSC program stayed in treatment longer and achieved greater improvement in their symptoms, personal relationships, involvement in work or school, and overall quality of life compared with patients who received typical care.3
Mobile care is a new frontier for mental health treatment. Applications, or apps, for electronic devices like cell phones and tablets are a convenient option for people who may have a hard time getting to an in-person appointment and can extend support for those who do attend in-person therapy sessions. With thousands of mental health apps now available, NIMH is funding research to explore what works and what doesn’t work in mobile care.4
The most effective treatment varies by mental health disorder and individual. Depression is usually treated by medications, psychotherapy, or a combination of the two.5 Mindfulness exercises may be effective for someone with an anxiety disorder, while people who have experienced trauma may find exposure therapy most helpful.6
Clinical Preventive Services
Healthcare providers are advised to screen adolescents in five areas to identify any mental health concerns: alcohol use, child maltreatment, depression, illicit drug use, and suicide risk. Health insurance plans generally cover these screening services without out-of-pocket costs.
For people receiving mental health care, supportive services help them meet their treatment goals. These services can include case or care management to help coordinate behavioral health services with health care as well as services related to housing, employment, education, and other supports. One promising example of support services for caretakers is the National Alliance on Mental Illness’s Family-to-Family program, a free 12-week course that has shown positive results in relieving the stress and improving the coping skills of those who care for a family member with mental illness.7 The Sibling Support Project offers Sibshops for siblings of children with mental health needs.
In combination with treatment, recovery support services can help young people build a life that sustains recovery as they work to manage symptoms though traditional treatments or peer-support groups. These types of services encourage positive relationships between people with mental and/or substance use disorders and their families, peers, and communities. Peer support and social inclusionmodels have demonstrated success in facilitating recovery and reducing health care costs. These services are designed and delivered by people who have experienced mental health and/or substance use disorders and are in recovery themselves.
Crisis Intervention Services
Supportive services also include crisis intervention services, which can help law enforcement or other first responders react compassionately and effectively to people experiencing a mental health crisis. Examples include the Crisis Intervention Team model (developed for the law enforcement community) and Youth Mental Health First Aid, a course designed for parents, family members, teachers, school staff, peers, neighbors, health and human services workers, and other caring citizens.8,9
Assertive Community Treatment (ACT) is an evidence-based practice that improves outcomes for people with severe mental illness who are at high risk of homelessness, psychiatric crisis and hospitalization, and involvement in the criminal justice system. When individuals are involved in multiple public systems, a single point of contact can help coordinate care and engage all the system partners in planning and delivering services. For young people, this is often done through a wraparound process, or an individualized process that builds strong relationships between the child and family or service providers.
Adolescents with mental illness may be entitled to educational accommodations under the Individuals with Disabilities Education Act through 12th grade. College students may be able to take advantage of accommodations provided by the Americans with Disability Act, but students may need to advocate for themselves to get these accommodations. Many colleges also offer free counseling or referral services to enrolled students free of charge. In 2016, approximately 18 percent of college students reported receiving help from their current college’s counseling or health services for mental health concerns.10