Schizophrenia has long been associated with the haunting echoes of voices, shaping public perceptions and treatment approaches alike. However, the essence of this condition extends far beyond the auditory hallucinations. It is a complex interplay of cognitive, emotional, and social dimensions that demands a holistic re-evaluation. 

The European Brain Council (EBC) “Rethinking Schizophrenia: Beyond the Voices” is the first part of a research-driven project “Rethinking Schizophrenia”, offering tangible policy and care pathway changes to improve the lives of people living with schizophrenia across Europe. It challenges the status quo and refreshes the European policy debate on people living with schizophrenia, recognises the essential role of social support and encourages multi-stakeholder-driven policy. 

In the second part of the project, EBC together with the European Psychiatric Association, the Board of Experts and Patients Associations representatives will share how mental health services are addressing the needs of young individuals with first episode psychosis. Despite some positive developments, there are still many deficiencies along the schizophrenia care pathway in Europe. The results will be released in the Spring of 2025.  

Rethinking the Schizophrenia Care Pathway 

Psychotic disorders, particularly schizophrenia, are severe mental illnesses associated with significant disability and societal costs. With a typical onset during late adolescence or early adulthood, schizophrenia requires lifelong treatment, combining pharmacological and non-pharmacological approaches. Early symptom recognition and timely interventions can greatly enhance functional recovery, however recent reports have identified significant gaps in access to timely assessment and shared decision-making, compounded by the unprecedented demand for mental healthcare among young people. Such high demands create challenges for health care services in delivering not only timely and evidence-based care but also safe and person-centered, as recommended by the World Health Organization. There is a need to improve prevention and care of young individuals with first episode psychosis (the onset of schizophrenia) to safely and effectively transition between various types of care tailored according to individual needs.  

To address these issues, the Rethinking Schizophrenia project is conducting an analysis of patient care pathways across nine European countries (Belgium, Denmark, France, Germany, Hungary, Italy, Poland, Spain, and the UK). This project aims to put forward an in-depth patient care pathway analysis in order to define specific strategies to advance the prevention and treatment of schizophrenia. Findings will inform policy recommendations to enhance care pathways for young individuals experiencing first-episode psychosis. 

Building on the first part of the project, the survey and literature review aim to: 

  • evaluate the effectiveness of integrated models of youth mental healthcare on a broader range of outcomes, including both mental health outcomes, such as clinical symptoms, functioning and quality of life and health service outcomes, including access and satisfaction with care in young people; 
  • identify the common components of integrated care pathways for young people with first episode psychosis. 

 Using the care pathway as a tool at the first step of the research, a cross-country survey was co-designed with the Board of experts and anonymously launched earlier this year. By complementing the survey, the literature review on the care pathway will address quality and continuity of care from the first onset of psychosis and schizophrenia to long-term care in the selected countries including existing guidelines and overview country health system situation. Patients and mental health professionals’ insights will be collected. Obtained data will also be analysed by the stakeholders and used to formulate recommendations for policy makers, care payers, mental health professionals, patients and their families (both country specific and at the EU level). 

A policy report, based on the consensus, will be released in the Spring 2025 with results and recommendations which will provide valuable insight into understanding the needs of patients with first-episode psychosis and defining the optimal care pathways to engage with them.