Schizophrenia Care: A Giving Smarter Guide

This Giving Smarter Guide examines care models and care delivery systems for schizophrenia, identifies shortcomings in the current care landscape, and outlines strategic philanthropic funding opportunities to improve schizophrenia care.

The roughly 24 million individuals affected by schizophrenia experience a variety of symptoms—most notably psychosis—compounded by significant challenges in accessing the appropriate care.

Effective treatment for schizophrenia entails introducing individuals to comprehensive care, ideally as early as possible. Comprehensive care should:

• address clinical symptoms;
• support individuals as well as their families;
• help individuals stay connected to their communities; and
• enable participation in meaningful work, education, or other activities.

However, significant barriers to effective treatment remain, even though the existing care system includes many essential services that each address different aspects of schizophrenia, from crisis response and early detection to intensive treatment and ongoing support. Many individuals do not receive timely treatment, with psychosis often untreated for months, leading to repeated cycles through emergency services, hospitalization, homelessness, and the criminal justice system—at an estimated annual cost of over $300 billion in the United States alone. Care is frequently fragmented among siloed programs with limited continuity between them. And access to otherwise effective programs may be constrained by high costs, restrictive eligibility criteria, treatment limits, and long waitlists.

Yet optimism is still warranted. A range of care models—from coordinated specialty care for early intervention to Assertive Community Treatment teams for ongoing support and clubhouses for community connection—have demonstrated success. Immediate opportunities exist to build on this success and develop improved, coordinated care so that people with schizophrenia can thrive.

The Giving Smarter Guide identifies three core opportunities that, together, aim to improve access to care while building toward a sustainable, cohesive system:

• scale evidence-based care programs
• strengthen care delivery systems
• increase connectivity across the care system

This report follows the companion publication Schizophrenia Research and Care: Assessment of Challenges and Opportunities, which examines five key areas: scientific research, clinical treatment, care models, social contexts, and systemic barriers. Together, these two publications describe a strategic approach to advancing schizophrenia research and care.