Despite robust evidence on effective interventions, epidemiologic and clinical surveys have established that individuals with schizophrenia in the United States are unlikely to receive these effective treatments.11 Epidemiologic data from the National Comorbidity Study in the early 1990s showed that 60% of persons with serious mental illnesses received no treatment in the past year, 25% received clearly inadequate treatment, and only 15% received minimally adequate (far short of evidence-based) treatment.12 The Schizophrenia PORT study similarly found that patients in 2 large state public mental health programs were unlikely to receive most of the indicated evidence-based practices.13 More recently, the 2005 National Survey on Drug Use and Health14 found that only 8.5% of adults who reported both serious psychological distress and a substance use disorder received any treatment (again far short of evidence-based treatment) for both problems in the past year. Several recent studies indicate that quality of care may be worsening rather than improving.15–17 Thus, even as researchers continue to develop more effective interventions for the treatment of schizophrenia, the preponderance of individuals with this disorder, perhaps as many as 95%, receive either no care or less than optimal care. Previous articles in this special section have reviewed the epidemiology of services and the problems of engagement and retention. In this article, we review efforts to implement effective interventions for schizophrenia in routine mental health treatment settings and offer suggestions for narrowing the gap between science and practice.