Personalized Medicine in Schizophrenia: Moving Beyond Diagnosis to Patient-Centered Care

In schizophrenia care, personalized medicine is less about novel biomarkers and more about deeply understanding the individual sitting in the exam room, according to Tracy Hicks, DNP, FNP/PMHNP-BC, a dual-certified family and psychiatric mental health nurse practitioner.

In an interview with Psychiatric Times, Hicks, who opened a comprehensive community behavioral health center in 2020, described a model of care that integrates clinical insight with social context, patient goals, and collaborative decision-making, an approach she believes is gaining traction but still unevenly applied.

“Personalized medicine…means moving beyond the diagnosis alone and really understanding the individual clinically, socially, [and] behaviorally,” Hicks said. That includes evaluating symptom profile, comorbidities such as substance use, cognitive function, and social determinants of health, while also centering “the patient’s goals and preferences.”

Elevating the Patient Voice

Hicks emphasized that even simple clinical practices can uncover critical insights. In her clinic, health care professionals routinely ask patients, “What is your goal for today?” She noted that this question often reveals priorities that may diverge from clinician assumptions, reinforcing the need for shared decision-making.

“What we think the patient needs, they may need something totally opposite,” she explained.

Her perspective is shaped by both professional and personal experience. Hicks has worked as a nurse since 2001 and founded an integrated behavioral health clinic that includes pharmacy collaboration, case management, peer support, and primary care services.

She also serves as a caregiver to family members with serious mental illness, including schizophrenia and bipolar disorder. This dual lens informs her emphasis on meeting patients where they are and incorporating care partners when appropriate.

Team Based Care in Practice

Team-based care is central to operationalizing personalization, she added. Hicks described daily team huddles to review each patient’s needs, anticipated follow-up, and the potential role of family or caregivers.

While some patients may initially resist involving family, she encouraged clinicians to remain open and exploratory. “A lot of times that family member is going to be the one that’s going to help you as a provider…really understand what the patient needs,” she said.

Rethinking Treatment Selection

Pharmacologic decision-making is another area where personalization can be strengthened. Hicks urged clinicians to remain curious and avoid defaulting to familiar medications, just because its comfortable for the clinician.

This includes considering a broader range of treatment options, such as long-acting injectables, when aligned with patient preferences and clinical context, she said.

Equally important is transparent communication about risks. Hicks highlighted the role of anticipating and managing adverse effects through proactive planning. “This particular side effect could happen…but this is the plan,” she tells patients. She also encourages her team to follow up within days of initiating a new treatment. This approach, she noted, builds trust and supports adherence.

Building Momentum Toward True Personalization

Despite ongoing challenges, Hicks sees momentum building. “We’re getting there,” she said, pointing to increased discussion of holistic and personalized approaches across clinical settings and professional forums.

For practicing psychiatric clinicians, her message is pragmatic: Personalization does not require new technology so much as a shift in mindset. By integrating clinical evidence with patient experience, leveraging team-based care, and maintaining curiosity, clinicians can deliver more effective, individualized care for patients with schizophrenia.

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