SAMHSA Issues Report About Cost and Financing Strategies for Coordinated Specialty Care for First Episode Psychosis

The Substance Abuse and Mental Health Services Administration (SAMHSA) issued a new report today: Coordinated Specialty Care for First Episode Psychosis: Costs and Financing Strategies which gives states financing strategies to provide critical services for first episode psychosis.

Every year, an estimated 100,000 people in the U.S. experience first episode psychosis, the early period of psychotic symptoms. Psychosis is a condition that affects the mind, where the individual experiences some loss of contact with reality. Coordinated Specialty Care (CSC) is a multi-component, evidence-based, early intervention service for individuals experiencing a first episode of psychosis that can improve their quality of life and social and clinical outcomes.

The new SAMHSA report provides an overview of the costs and outcomes of providing services for first episode psychosis and strategies for financing the services in different states. It also discusses innovative approaches to financing other team-based behavioral health services that may be adopted for CSC. The report provides an understanding of the challenges associated with financing CSC services and a summary of approaches to improve funding for this critical mental illness treatment service.

“Early diagnosis and treatment are shown to result in improved outcomes and a much better chance of recovery. This is critical for someone experiencing first episode psychosis,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “This report is a game changer for helping states identify funding so they can provide access to treatment for the people in their community.”

Timing is important in the treatment of first episode psychosis, and the more treatment is delayed, the worse the outcomes are for individuals. As highlighted in SAMHSA’s new report, research shows that individuals who receive CSC for first episode psychosis achieve better health outcomes and better chances of recovery. They also experienced fewer hospitalizations and better vocational engagement, and they reported greater improvements in quality of life and fewer depressive symptoms than those receiving standard community treatment. These improvements are important not just for quality of care, but for helping individuals regain and maintain positive life trajectories despite the many challenges that come with a diagnosis of serious mental illness.

Funding CSC is often a challenge, according to the SAMHSA report, as the traditional fee-for-service reimbursement model does not cover all evidence-based service components necessary for treatment effectiveness, and office-based rates are inadequate for the services covered. SAMHSA’s report details sources of sustainable funding, so that states can take advantage of a wider array of financing approaches to allow them to implement CSC for first episode psychosis on a broader and more equitable basis.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. To learn how to get support for mental health, drug, and alcohol issues, visit FindSupport.gov.

Reporters with questions should send inquiries to media@samhsa.hhs.gov.


The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

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