Diagnostic clarification
Review of symptom course, records, collateral information, and differential diagnosis when the nature or cause of psychosis remains uncertain.
Why this matters
- Massachusetts General Hospital
- Harvard Medical School
Expert clarity across every stage of psychosis.
We provide diagnostic clarity and expert pharmacotherapy recommendations for clinicians treating people with psychotic disorders, throughout all stages of illness.
What we provide
A comprehensive consultation
Second-opinion consultations are standard in many areas of medicine when a diagnosis is uncertain or treatment is not working. Psychosis care should be no different. Timely consultation can clarify the diagnosis, guide evidence-based treatment, and support the existing care team.
Treatment-resistant schizophrenia
Assessment of prior antipsychotic trials, treatment resistance, clozapine candidacy, and next-step strategies when symptoms persist.
Why this matters
Medication strategy & safety
Recommendations on medication optimization, side effects, physical-health monitoring, adherence challenges, and medical complexity.
Why this matters
Adolescents & young adults
Developmentally informed assessment of emerging psychosis, diagnostic uncertainty, treatment planning, and family involvement.
Why this matters
Family education & support
Guidance that helps families understand psychosis, communicate effectively, support recovery, and collaborate with the treatment team.
Why this matters
Recovery & community integration
Attention to functioning, relationships, school or work, community supports, treatment engagement, and recovery-oriented goals.
Why this matters
By the numbers
A track record clinicians already trust.
Between January 2017 and October 2023, providers from a wide range of settings referred patients to us for expert diagnostic clarification and treatment recommendations.
- 28%
- Received a new schizophrenia diagnosis after review
- 56%
- Of treatment-resistant cases were identified only at consultation
- 9–77
- Patient age rangeMean age 29.1
- 73%
- Referred by psychiatrists or psychiatric NPs
- 72%
- Lived in MassachusettsThe majority of referrals
Who refers to us
- Psychiatrists54%
- Psychiatric nurse practitioners19%
- Primary care & other physicians22%
- Other5%
Referring practice setting
- Community clinicians52%
- Academic medical centers25%
- Other sources23%
How it works
A clear path from referral to follow-up.
- 1
Treating clinician
Clinician submits a referral
The treating psychiatric provider completes a short online referral form to get the consultation started.
- 2
Consultation team
Specialists meet with the patient
The consultation team completes a comprehensive evaluation and offers psychoeducation for the patient and family.
- 3
Consultation team
Recommendations return to the clinician
Clear, actionable, stage-appropriate recommendations are sent directly to the referring clinician.
- 4
Treating clinician
Treating clinician implements the plan
The patient continues with the treating provider, who puts the recommendations into practice.
- 5
Consultation team
Another consultation is possible
Patients may return in 1–2 years for another consultation.
Where to start
Find the path that fits you.
Primary pathway
For Clinicians
Submit a referral for expert consultation on schizophrenia and psychosis care across every stage.
Refer a patientGuidance
For Patients & Families
Interested in a consultation? Please speak with your treating clinician. Only a treating clinician can submit a referral on your behalf.
Beyond the U.S.
For International Patients
Patients living outside the United States can contact Mass General Brigham International Patient Services to help coordinate their care.
International Patient ServicesOur team
Multidisciplinary expertise for schizophrenia and psychosis.
Team participation is tailored to the consultation question and the needs of the patient, family, and referring provider. Consultations are led by faculty at Massachusetts General Hospital and Harvard Medical School.
Oliver Freudenreich, MD
Director
Professor of Clinical Psychiatry, Harvard Medical School · Co-Director, MGH Psychosis Clinical & Research Program
Dr. Freudenreich directs the consultation service and provides expert guidance for clinicians managing complex cases. His clinical work focuses on optimal psychopharmacologic treatment for schizophrenia, treatment-resistant psychosis, and psychiatric consultation for medically complex patients.
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Abigail Donovan, MD
Associate Director
Assistant Professor of Psychiatry, Harvard Medical School · Director of Clinical Services, MGH Psychosis Clinical & Research Program
Dr. Donovan specializes in the early detection and treatment of schizophrenia in adolescents and adults. Her work emphasizes developmentally informed assessment, outcome-based care, and quality improvement.
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Cori Cather, PhD
Director, Center of Excellence for Psychosocial & Systemic Research
Associate Professor of Psychology, Harvard Medical School
Dr. Cather is a clinical psychologist whose research develops and implements cognitive behavioral approaches for residual symptoms, medication adherence, and substance use in schizophrenia spectrum disorders.
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Carol Lim, MD, MPH
Medical Director, MGH Clozapine Clinic
Assistant Professor of Psychiatry, Harvard Medical School
Dr. Lim leads the MGH Clozapine Clinic and educational initiatives that help healthcare systems establish safe, effective clozapine monitoring. Her work focuses on treatment-resistant psychosis and medication optimization.
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Cheryl Foo, PhD
Director of Family Services
Assistant Professor of Psychology, Harvard Medical School
Dr. Foo is a clinical psychologist and implementation specialist. She leads efforts that help clinicians and healthcare systems deliver clozapine and long-acting injectable treatment safely, alongside family-centered psychosocial care.
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Sarah MacLaurin, PMHNP-BC
Psychiatric Nurse Practitioner & LAI Specialist
Sarah MacLaurin provides expert, recovery-oriented clinical care and specializes in long-acting injectable antipsychotic medications. She also offers consultation and training to healthcare providers.
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John Tyson, MD
Child & Adolescent Psychiatrist
Instructor in Psychiatry at Harvard Medical School
Dr. Tyson is a child and adolescent psychiatrist focused on diagnostic assessment and treatment planning for adolescents and young adults. At Mass General, his work includes first-episode and early psychosis care.
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Leah Namey, MPH
Program Manager
Leah Namey manages program operations and oversees quality improvement initiatives across the consultation service and the broader TRS ACCESS program.
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Marta Hernandez
Program Coordinator
Marta Hernandez coordinates program activities and provides administrative support for patient care and program operations.
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Molly McCarthy
Senior Director of Development
Molly McCarthy leads philanthropy and development for the MGH Department of Psychiatry, supporting the growth of the psychosis consultation service and its ability to reach patients and families.
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In their words
Voices from patients, families, and providers.
The impact of a consultation is measured in trust regained and outcomes improved.
After years of trying different medications, the consultation gave my psychiatrist a clear plan. For the first time, I felt like everyone understood what I was living with.
Illustrative examples shown while we gather consented quotes from those we have served.