Rethinking schizophrenia: Optimizing care pathways in Europe from the first episode of psychosis to long-term care

BACKGROUND: The European Brain Council project "Rethinking Schizophrenia" aims to examine the existing state of patient care pathways across Europe. The study objectives of Phase 2 were to evaluate the current models of schizophrenia care on mental health outcomes, access and satisfaction with care, and to identify the foundations of integrated care pathways for young people with first-episode psychosis. METHODS: Using the care pathway, a questionnaire was developed and anonymously disseminated to mental health professionals in nine European countries (Belgium, Denmark, France, Germany, Hungary, Italy, Poland, Spain, and the United Kingdom). The survey included 45 questions and addressed the quality and continuity of care from the first onset of psychosis to long-term care, including assessment of the mental health care systems. RESULTS: A total of 203 responses were obtained. The majority of mental health professionals were psychiatrists (75%), followed by psychologists (11%), nurses (7%), social workers (2%), and GPs and others (5%). The responses were analyzed qualitatively. The results revealed dissatisfaction with the current state of schizophrenia care systems and significant variability in quality of care. The factors that affect the care pathways most are assessment and early intervention services, continuity of care, availability of various types of services and treatments, collaborative decision-making, and utilization of new technologies. CONCLUSIONS: A comprehensive, integrated approach is essential to improve schizophrenia care across Europe. This strategy emphasizes early intervention, equitable access to treatments, coordinated care models, psychosocial support, and long-term recovery through a biopsychosocial framework and emerging technologies.