Clinical trials in schizophrenia have been too small, too short, and too exclusionary — leaving out up to 80% of real-world patients and failing to measure what actually matters to people's lives, like negative symptoms and functioning.

New trial designs — including platform trials, adaptive methods, and SMART designs — offer a way to test multiple treatments simultaneously, include harder-to-reach patients, and generate evidence that reflects the true complexity of the illness.

The societal cost of schizophrenia in the US alone reached $367 billion in 2024, yet mental health research receives just £9 per patient compared to £2,000 for cancer — making ambitious, sustained investment not just a scientific priority, but a moral and economic imperative.