Schizophrenia Care: A Giving Smarter Guide

Schizophrenia is a serious, chronic brain disorder affecting about 24 million people worldwide. Individuals with schizophrenia experience a variety of symptoms—most notably psychosis—and face significant challenges accessing the care they need.

This Giving Smarter Guide examines care models and care delivery systems for schizophrenia, identifies shortcomings in the current care landscape, and outlines strategic philanthropic funding opportunities to improve schizophrenia care.

Effective treatment for schizophrenia introduces individuals to comprehensive care—ideally as early as possible. Comprehensive care should:

• address symptoms;
• support individuals with schizophrenia as well as their families;
• help keep individuals with schizophrenia connected to their communities; and
• enable participation in meaningful work, education, or other activities.

The existing care system includes many essential services that each address different aspects of schizophrenia, from crisis response and early detection to intensive treatment and ongoing support. Yet significant barriers to effective care remain. Many individuals do not receive timely treatment, with psychosis often untreated for months, leading to repeated cycles through emergency services, hospitalization, homelessness, and the criminal justice system—at an estimated annual cost of over $300 billion in the United States alone. Care is frequently fragmented, with programs operating in isolation and limited continuity when services end. Access to effective programs is further constrained by high costs, restrictive eligibility criteria, treatment limits, and long waitlists.

Despite these challenges, momentum for change is building. A range of care models—from coordinated specialty care for early intervention to Assertive Community Treatment teams for ongoing support and clubhouses for community connection—have demonstrated success. Immediate opportunities exist to build on this success and develop improved, coordinated care so that people with schizophrenia can thrive.

The Giving Smarter Guide identifies three core opportunities that, together, aim to increase access to care while building toward a sustainable, cohesive system: 

• scale evidence-based care programs
• strengthen care delivery systems
• increase connectivity across the care system

This report follows the companion publication Schizophrenia Research and Care: Assessment of Challenges and Opportunities, which examines five key areas: scientific research, clinical treatment, care models, social contexts, and systemic barriers. Together, these two publications reflect a strategic approach to advancing schizophrenia research and care.