{"id":46267,"date":"2014-05-16T20:55:34","date_gmt":"2014-05-17T00:55:34","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=46267"},"modified":"2014-05-16T20:58:29","modified_gmt":"2014-05-17T00:58:29","slug":"out-of-the-loop","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/05\/16\/out-of-the-loop\/","title":{"rendered":"out of the loop…"},"content":{"rendered":"\n

I realize that nosing around the NIMH RAISE<\/em> Project is a little different than many of the things I write about here. Usually, I’m rooting around looking for corruption peeking out from behind the spin. But here, I’m looking for something else. I want these early psychosis programs to work. A career of seeing what the psychosis of young adults we call Schizophrenia can do to a life has been difficult. The medications available can eliminate the most troubling symptoms but they’ve been overutilized and are no long term solution. And I’m sure that the place to to start is early – before the psychosis erupts if possible, but certainly as soon as it shows its head. I had such a case [1. from n equals one<\/em>…<\/a>], and I’m convinced that the course of the illness can be altered. But, thus far, no one has been able to construct a viable  program that endures. There are all kinds of initiatives around the world trying right now – notably Dr. McGorry’s program in Australia [which gets mixed reviews]. RAISE<\/em> is apparently our current shot, and I want it to be more than simply another well-intentioned-but-likely-to-fizzle<\/em> program going large prematurely.<\/p>\n

I found things that explain some of what was going on with RAISE<\/em> by looking at some old NIMH News releases, but the cost accounting and the details of how it all happened still elude me:<\/div>\n
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Recovery Act Funds Will Support First Phase of Project<\/a><\/div>\n
NIMH Science News<\/font><\/strong><\/div>\n
July 21, 2009<\/div>\n

The National Institute of Mental Health [NIMH] is launching a large-scale research project to explore whether using early and aggressive treatment, individually targeted and integrating a variety of different therapeutic approaches, will reduce the symptoms and prevent the gradual deterioration of functioning that is characteristic of chronic schizophrenia. The Recovery After an Initial Schizophrenia Episode<\/a> [RAISE] project is being funded by NIMH with additional support from the American Recovery and Reinvestment Act [ARRA]. RAISE is a model example of how money from the Recovery Act can accelerate science related to public health problems and potentially benefit those citizens most in need…<\/p>\n

RAISE will test approaches that involve intervening immediately upon first diagnosis, systematically incorporating the range of options that are now available in a more piecemeal fashion to people with schizophrenia. These options include medications, psychosocial treatments, and rehabilitation, including teaching patients and families how to manage the disease. The hope is that such a coordinated approach tailored to each individual and sustained over time may make lasting differences in the acceptability of treatment and overall function… <\/p>\n

Two research groups will work in parallel to develop and test potential intervention approaches. One group will be led by John M. Kane, M.D., of the Zucker Hillside Hospital, Feinstein Institute for Medical Research, Manhasset, N.Y. The second group will be led by Jeffrey Lieberman, M.D., of the Research Foundation for Mental Hygiene, Inc., New York City. The research teams feature national and international collaborations, with treatment to be delivered in up to 30 clinical sites across the United States. Recovery Act funds will underwrite the initial two phases of the trial, during which the investigators will refine the interventions with input from stakeholders and conduct a feasibility study to demonstrate that each intervention can be fielded in real world community treatment settings and be evaluated in a randomized clinical trial design. With long-term funds committed by NIMH to complete these phases plus a full-scale clinical trial, funding for the study is $40 million…<\/div>\n<\/blockquote>\n
And this next release clarifies some of what was bothering me earlier [a fabrication?…<\/a>, where’s the beef?…<\/a>]. You’ll notice that the RAISE Connection<\/em><\/font><\/strong> links [in red<\/font><\/strong>] don’t work. That site has been taken down. But through the wonders of the Wayback Machine<\/a>, you can see the iterations of the site from January 17, 2011 thru December 30, 2013 showing the multiple changes in personnel, locations, and services described in the earlier posts:<\/div>\n
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NIMH RAISE Project Makes Progress as Teams Refine Research Approaches<\/a><\/div>\n
NIMH Science News<\/font><\/strong><\/div>\n
August 9, 2011 <\/div>\n

<\/p>\n

Researchers continue to make progress in the NIMH Recovery After an Initial Schizophrenia Episode<\/a> [RAISE] Project, which seeks to intervene at the earliest stages of illness in order to prevent long term disability. Recent refinements to the two RAISE studies will ensure that RAISE continues efficiently, and generates results that will be relevant to consumers and health care policy makers.<\/div>\n