Making early intervention for psychosis feasible in India: Lessons from two decades of SCARF's first episode psychosis program.

Abstract

Early intervention in psychosis (EIP) has long been recognized as the critical determinant of long-term outcomes, yet in India, it remains largely absent from routine psychiatric care. This viewpoint reflects on two decades of experience at Schizophrenia Research Foundations (SCARF's) First Episode Psychosis (FEP) program in Chennai, offering grounded insights into how early intervention can be adapted to low-resource contexts without reliance on complex infrastructure. Drawing from lessons shaped in real time: through embedded services, hybrid follow-up models, and family-centered approaches, it argues that meaningful care can begin not only at the earliest signs of illness, but also at the point individuals first seek help. The paper challenges the assumption that specialist-heavy models are the only path to success, proposing instead a simple, responsive, and scalable model rooted in contextual realities. In doing so, it calls for a shift in how early psychosis is understood, engaged, and supported across India.