A landmark study into the treatment of newly diagnosed schizophrenics has found that talk therapy combined with medication can be more effective in treating symptoms than just strong doses of drugs.
The findings, which emphasize the success of therapy and how unusual it is for schizophrenics to be treated with it, could help shift the way health insurers in the United States cover mental health treatment costs.
Researchers spent four years studying more than 200 newly diagnosed schizophrenics. Half of the subjects were treated solely with medication, while the other half received a lower-dose medication combined with individual therapy, coaching sessions in the workplace or school, and family counseling.
The study involved patients at 34 treatment centers in 21 states. The results, released Tuesday in the American Journal of Psychiatry, found that individuals in the early stages of schizophrenia were better off receiving lower-doses of antipsychotics in conjunction with therapy. The National Alliance of Mental Illness (NAMI) praised the study and said it would be used as part of the organization's push to broaden access to services for the mentally ill.
Ken Duckworth, director of NAMI, said the research was compelling because it was the first national study of its kind to look at the framework for how mental illness is treated in its early stages. Duckworth compared the currently robust early-intervention treatments available for diabetes, heart disease, and other illnesses to the limited options available for schizophrenics.
"For psychosis, we really hadn't conceptualized an early-intervention model. So this is cool because it takes that idea and gives people services we know work, and it turns out they do better in work, in school, and in their level of stress," he said. "This proved what many of us thought was probably true but until you prove it you don't have it."
The researchers behind Tuesday's study intend to look next at the costs of treatment that combines therapy and medication, versus an approach that relies strictly on medication, Duckworth said.
"If you can demonstrate that you're reducing hospital expenses by providing other services, and thereby saving the system money, it's quite likely they'll be expanded," he said.
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Though many medical professionals had already been working under the assumption that therapy was important in addition to medications, this study is the first to offer proof, he said. Duckworth attended a hearing on Capitol Hill on Tuesday with the study's authors, who were unavailable for comment to VICE News. Together, they encouraged Congress to push forward in their work on mental health reform bills in both houses.
Dr. Jeffrey Borenstein, president of the Brain and Behavior Research Foundation, explained that health insurers will often not pay for the types of therapies that were found to be so successful in the study, covering merely the pharmaceutical treatment instead. This study could help change that.
"This type of evidence can help the development of more programs like this so there's more resources available to people with schizophrenia and also encourage support for those kinds of programs from government insurers and private insurers," Borenstein said. "This study that proves the benefit of this, that therapy is key, hopefully will be a part of the push to have that therapy paid for by the insurers."
Mental health advocates emphasized that pharmaceutical treatment is still absolutely necessary for schizophrenics, and said that therapy alone is not enough. But the focus of the healthcare industry should be broadened to include therapy and encourage access to early treatment, they said.
"As a culture, how do we encourage people into care, and how stigmatized is the condition? How welcoming are our community centers? These are really the kind of questions that I think every person who is seriously interested in mental illness has to face," Duckworth said.
Linda Stalters, executive director of the Schizophrenia and Related Disorders Alliance of America, said that patients with schizophrenia often can't afford therapy costs on their own, and will choose to go off their high-dose medications because of negative side effects. Others choose to rely solely on medication because of the belief that it offers faster results than therapy.
"People need support and they need real therapy and medications," Stalters said.
She added that therapy can help schizophrenics cope with their symptoms, and to better understand what factors cause stress that can triggers symptoms.
The study's release coincided with hearings on Capitol Hill for mental reform amid a bipartisan push to improve mental health treatment, partially due to the increase in mass shootings in which mental illness is thought to have played a role.
Follow Colleen Curry on Twitter: @currycolleen