topics Educational Resources First Episode Psychosis Care

First Episode Psychosis Care

The Challenge

Each year, 3,000 Texas adolescents and young adults first experience a psychotic episode. Most have health insurance through their parents, but they do not typically receive care and treatment until five years after first onset. Studies show that the longer treatment is delayed, the worse the outcome, both for the individual and for society.

A new approach called First Episode Psychosis (FEP) Care starts treatment as early after initial psychosis as possible and helps people remain on their developmental trajectories. A team of specialists provides FEP care, including a psychiatrist, employment/education specialist, nurse, substance abuse counselor, peer coach, and outreach specialist.

First Episode Psychosis Care is Effective

The American Journal of Psychiatry reported that, especially when receiving FEP care within the first 17 months of psychosis onset, participants achieve a better quality of life and are more involved in work and school. FEP care is better than care-as-usual at helping people remain on a normal developmental path.

FEP care is cost-effective as well. On average FEP care costs less than $9,000 per person per year. That’s less than two-thirds the cost of providing intensive care when it is typically provided—after years of suffering.


A recovery-oriented program helped Margaret learn how to manage her schizophrenia after her first psychotic episode.

What Can Texas Do?

FEP care is currently being tested by pioneering providers in Dallas and Houston, and in 2016 eight new FEP care sites were being funded statewide by the Texas Department of State Health Services. Texas needs to take steps to bring FEP care “to scale.” Suggested steps include:

  • Implement policies that ensure health plans can work with providers to pay for the early detection and treatment of psychosis.
  • Develop a forum through which FEP care providers can hone increasingly cost-effective approaches by sharing their findings and innovative strategies.
  • Better track the success of FEP care statewide including more precise estimates of new cases of psychosis annually, the number of people receiving early care, and the related outcomes and costs of care.

Further Reading