We help clinicians and health systems deliver timely, safe, evidence-based care—through consultation, education, and hands-on implementation support, so people get the right care from their own providers.
Treatment-Resistant Schizophrenia (TRS) Advocacy, Clinical Consultation, Education, and Support Service (ACCESS)
Building a network for accessible evidence-based TRS treatment
Clozapine is the only FDA-approved medication for TRS, yet it is significantly underused. In the post-REMS era, with simplified monitoring requirements and updated clinical guidelines, there are fewer barriers to clozapine access than ever before.
TRS ACCESS is building a network of clinicians and clinics ready to deliver timely, evidence-based TRS care. We help health systems and providers expand safe, effective use of clozapine and long-acting injectable antipsychotics, improving outcomes for people with TRS.
Courtesy of Oliver Freudenreich
The TRS ACCESS Network is supported by the generous philanthropy of the CNR Foundation.
MGH TRS ACCESS Network and Makerere University collaboration advancing schizophrenia and clozapine care in Uganda
Key findings from major studies on TRS and clozapine access.
A meta-analysis of 50 studies estimated a 36.7% prevalence of TRS.
Schizophrenia Research, 2023In a 45-state Medicaid study, clozapine represented only 5.5% of treatment episodes consistent with TRS.
Psychiatric Services; 2002–2005 dataAcross 11 U.S. health systems, fewer than 2% began clozapine within 12 months of a potential indication.
These findings come from different study populations and designs and should not be interpreted as estimates from a single cohort. The 5.5% figure reflects historical Medicaid data.
Abigail Donovan, MD explains our mission
Learn how TRS ACCESS helps clinicians prescribe clozapine and long-acting injectables safely and effectively for people with TRS.
Courtesy of Oliver Freudenreich
A lighthouse is a beacon of hope in a sea of uncertainty.
Clozapine is proven to be the most effective treatment for TRS, but many people never receive it. The TRS ACCESS Network exists to close this gap by supporting earlier, safer, and more consistent use of clozapine and other best-practice interventions.
We partner with clinicians, clinics, and health systems to:
Abigail Donovan, MD explains the importance improving health outcomes
Measuring and improving outcomes for people with TRS can transform lives and healthcare delivery. Our focus on outcome-based care helps ensure that every intervention leads to meaningful improvements in well-being and recovery.
Expert clinicians dedicated to TRS ACCESS services
Professor of Clinical Psychiatry, Harvard Medical School
Co-director, MGH Psychosis Clinical and Research Program
Oliver Freudenreich directs TRS ACCESS and leads its consultation service for clinicians managing complex psychosis.
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Assistant Professor of Psychiatry, Harvard Medical School
Director of Clinical Services, MGH Psychosis Clinical and Research Program
Abigail Donovan specializes in early detection, treatment, and quality improvement for schizophrenia care.
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Assistant Professor of Psychiatry, Harvard Medical School
Medical Director, MGH Clozapine Clinic
Carol Lim directs the MGH Clozapine Clinic and helps health systems establish safe clozapine monitoring programs.
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Psychiatric Nurse Practitioner & LAI Specialist
Sarah Maclaurin provides clinical care, consultation, and training focused on long-acting injectable antipsychotics.
Assistant Professor of Psychology, Harvard Medical School
Clinical Psychologist & Implementation Specialist
Cheryl Foo leads implementation support for safe, effective clozapine and long-acting injectable services.
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Program Coordinator
Marta Hernandez coordinates program activities and supports patient care and daily operations.
Program Manager
Leah Namey manages TRS ACCESS operations and quality improvement initiatives.
Comprehensive support for evidence-based TRS care
Direct clinical services and case consultation
Expert consultation for clinicians managing complex cases of difficult to treat psychosis, providing guidance on diagnosis, treatment planning, and clozapine initiation and management.
Helping clinics and health systems build the capacity to deliver safe, effective TRS care
We specialize in optimizing clozapine treatment, navigating today's regulatory landscape to ensure safe, effective prescribing. Our support includes protocol development, staff training, and education to uphold best practices in clozapine management.
Training and consultation on long-acting injectable antipsychotic medications, helping clinicians optimize medication adherence and improve treatment outcomes.
Implementation support to help healthcare systems and clinicians become capable of prescribing clozapine and long-acting injectable safely and effectively, including staff training, workflow development, and ongoing support.
Invite our faculty to speak with your team
Our faculty are available to deliver Grand Rounds, lectures, case conferences, and educational presentations on schizophrenia, clozapine, long-acting injectables, and related topics. We welcome invitations from academic medical centers, hospitals, community clinics, residency and fellowship programs, and professional organizations.
Please contact us with the proposed date, audience, format, and topic you have in mind.
Educational materials and publications from our faculty
Evidence-based clinical guidance from the MGH Psychosis Clinical and Research Program.
View / Download PDFArgues that the end of the clozapine REMS program is an opportunity to redesign monitoring so that medical follow-up tracks a clinical treatment framework with three phases: clozapine trial, treatment optimization, and treatment consolidation.
View ArticleA mixed-methods study of real-world adoption of a point-of-care fingerstick device for neutrophil monitoring at two outpatient clinics, finding that successful implementation depends on addressing patient preferences, staffing logistics, and sustainable financing.
View ArticleA conceptual review supporting earlier, routine clozapine use in TRS within a stage-based treatment framework, including strategies for safe use and overcoming barriers to access.
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Second Edition - A comprehensive guide to understanding and treating psychotic disorders in clinical practice.
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A guide for patients and families dealing with serious mental illness.
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Emergency Management - A comprehensive guide for managing substance use in psychiatric emergencies.
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Oliver Freudenreich, MD discusses secondary psychosis and differential diagnosis considerations.
Abigail Donovan, MD explains the spectrum of schizophrenia, covering causes, symptoms, and treatment approaches.
Educational presentation on TRS and clozapine treatment approaches.
Research seminar discussing current clinical research initiatives in psychosis treatment and management.
Get in touch with our specialized team
151 Merrimac St, Suite 401
Boston, MA 02114
617-643-1175