If you walk into an early psychosis programme almost anywhere in the United States today, the structure you encounter — a team that includes a prescriber, a therapist, a family clinician, an employment specialist, sometimes a peer — is in large part the legacy of a single research effort. That effort was the RAISE trial, funded by the National Institute of Mental Health and run between 2009 and 2014. It is one of the most consequential pieces of mental health research of the last quarter century.
RAISE showed that team-based, integrated treatment for first-episode psychosis produces better outcomes than usual care — and reshaped US policy and funding accordingly.
What RAISE stood for
RAISE — Recovery After an Initial Schizophrenia Episode — was a large NIMH-funded research initiative designed to test whether a coordinated, team-based approach could improve real-world outcomes for people in their first episode of psychosis. It had two main study arms:
- RAISE-ETP (Early Treatment Program) — a cluster-randomised trial of 34 community clinics across 21 US states, comparing the NAVIGATE intervention to usual community care. Led by John Kane and Delbert Robinson at Zucker Hillside Hospital.
- RAISE-IES (Implementation and Evaluation Study) — a real-world implementation study of the OnTrackNY model in New York, led by Lisa Dixon at Columbia.
The NAVIGATE intervention
NAVIGATE was the structured CSC model tested in RAISE-ETP. It included four major components delivered by a team:
- Personalised medication management (favouring low-dose, second-generation antipsychotics with shared decision-making)
- Family psychoeducation
- Individual resilience training (a structured cognitive-behavioural therapy)
- Supported employment and education
Crucially, the RAISE-ETP trial was pragmatic — it tested the intervention in real community clinics, not in academic specialty centres. This made the results directly relevant to how care is actually delivered in the US.
What RAISE found
The primary RAISE-ETP results were published by Kane et al. in the American Journal of Psychiatry, 2016. Over two years of follow-up, NAVIGATE participants showed:
- Greater improvement in quality of life
- Greater improvement in psychiatric symptoms
- Higher rates of school and work participation
- Better engagement and retention in treatment
One of the most important findings was a strong moderator effect of duration of untreated psychosis (DUP): the benefits of NAVIGATE were largest among participants who had had psychotic symptoms for less than about 18 months before entering the study. Those with longer DUP benefited less. This finding — that earlier identification matters as much as the treatment itself — has shaped the field's emphasis on reducing DUP at a population level.
Why it changed policy
RAISE was published into a receptive policy environment. The federal government, working through SAMHSA and the Mental Health Block Grant, used RAISE's results to require that states allocate a portion of their block grant funding to early-intervention services for first-episode psychosis. This 5% (later 10%) "set-aside" became the engine that funded the rapid spread of Coordinated Specialty Care programmes across all 50 US states.
Before RAISE, fewer than a dozen US programmes offered structured first-episode psychosis care. By the early 2020s, more than 350 programmes existed, supported in large part by the funding mechanism that RAISE helped justify.
What RAISE did not show
It is important to be honest about the limits of any single trial:
- RAISE compared NAVIGATE to usual care, not to other potentially good models. It is not the only effective approach.
- The two-year follow-up is short. Whether benefits are sustained over 5–10 years is still being studied.
- Effect sizes were meaningful but not dramatic. CSC reliably improves outcomes; it does not "cure" first-episode psychosis.
- Not every site implemented the model with equal fidelity, and outcomes varied accordingly.
The OnTrackNY contribution
The OnTrackNY arm of RAISE evolved into a state-funded service that has now treated thousands of young people across New York. Its open-access publications, training materials, and peer specialist integration have become reference points for programmes nationally. OnTrackNY's published outcomes (Dixon and colleagues) align closely with the RAISE-ETP findings: lower hospitalisation, better functional engagement, high satisfaction.
Where RAISE-influenced research is going
Several follow-on studies have built on RAISE:
- Connection-FEP and other comparative-effectiveness studies of different CSC components
- Extending duration — testing whether 5 years of CSC is meaningfully better than 2
- Digital additions — apps and remote monitoring layered onto CSC
- Reducing DUP at the community level — public-health campaigns, primary care training, and school-based screening
- Equity — ensuring CSC reaches communities historically left out of early intervention research
What this means for families today
For a family facing a first episode of psychosis, the RAISE legacy is direct and practical: there is now a national infrastructure designed specifically for this moment in someone's life. The standard advice is straightforward — find your nearest CSC programme as quickly as possible. Resources include:
- The NIMH list of CSC programmes by state
- SAMHSA's national helpline (1-800-662-HELP)
- NAMI affiliates (nami.org)
- Asking any inpatient psychiatric team for local first-episode psychosis services
The bigger picture
RAISE is one of the cleaner success stories in modern public mental health. A federally funded research programme tested a real intervention in real community clinics, found a real benefit, and prompted real policy change that put the intervention into widespread use. None of this is automatic, and the work of improving CSC continues. But for someone in their first episode of psychosis today, the structures around them are dramatically better than they would have been twenty years ago — and that change is a direct legacy of the RAISE investigators and the families who participated in their work.
This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Always consult a qualified mental health professional. If you or someone you know is in crisis, call or text 988 in the US, or your local emergency number.