Recognition of warning signs: a consideration for cost-effective treatment of severe mental illness

Warning signs of decompensation, also known as prodromal symptoms, and problems related to poor recognition of warning signs were examined in a sample of 370 adult outpatients with severe mental illness. Clinicians' ratings, client interviews, and eight months of client service records revealed that poor recognition of warning signs was a prevalent problem in this population and was related to poorer treatment outcomes and greater use of the most expensive types of services. Poor recognition was more likely to improve when it was specifically treated than when not treated. Improvement in recognition was related to better outcomes and lower costs. Results suggest the need for patients' recognition of warning signs to receive standardized assessment, treatment, and monitoring.