The Integration of Early Psychosis Services in a System of Care Framework: Opportunities, Issues

Since the beginning of the Substance Abuse and Mental Health Services Administration’s Children’s Mental Health Initiative in 1993, the system of care (SOC) framework has provided the foundation for community- based service development in the United States and has focused on improving the lives of children, youth, and young adults who experience the most complex mental health needs and their families. In recent years, with greater understanding of early psychosis, the SOC framework has expanded to include young adults presenting with signs of early psychosis. The SOC approach brings children, youth, and young adults with Serious Emotional Disturbance (SED)1 and their families together with community-based services and supports to create a network of care that is organized around common principles (i.e., family-driven, youth-guided care; culturally competent, evidence-informed and individualized) and outcomes (e.g., improved functioning at home, in school, and in the community). This approach establishes cross-system mechanisms for service planning, financing, and system improvement, and it increases access to home- and community-based services and supports that improve functioning, promote continuity, and decrease avoidable hospitalizations and out-of-home placements (Stroul, B.A., Blau, G.M., and Friedman, R.M., 2010; U.S. Department of Health and Human Services, 2015).