Services to improve outcomes in severe mental disorders.

Abstract

Severe mental disorders, particularly schizophrenia and related disorders, remain among the most disabling and costly health conditions worldwide. Despite advances in pharmacological and psychosocial treatments, recovery rates remain low. Early intervention has emerged as a key strategy to improve outcomes. Reducing the duration of untreated psychosis (DUP) and providing specialized early intervention services-such as Denmark's OPUS, the UK's LEO, and the US Recovery After an Initial Schizophrenia Episode (RAISE) trial-have shown significant benefits in symptom reduction, functioning, and cost-effectiveness. Assertive Community Treatment (ACT), Individual Placement and Support (IPS), and Housing First programs further enhance recovery for individuals with complex needs, including comorbid substance use and homelessness. Innovative therapies, such as avatar-based treatment for persistent hallucinations, show promise in treatment-resistant cases. Children of parents with severe mental illness are at elevated risk and offer a unique opportunity for prevention. The Danish High Risk and Resilience Study (VIA 7), which follows high-risk children from age 7 to 19, exemplifies how longitudinal research can identify early modifiable risk factors and inform timely interventions. To improve long-term outcomes, services must be coordinated, person-centered, and recovery-oriented-delivering care that is accessible, humane, and tailored to the individual's stage of illness and life circumstances.