By Mary Giliberti, J.D.
What if we could dramatically change the trajectory of a young person's life by identifying psychosis early? It turns out we can, but only by delivering the right care at the right time. And that's not happening often enough.
A recently published study shows that we have an abysmal record in identifying psychosis early. In the U.S., a young person experiences psychosis for about one to three years before getting treatment. While the U.K., which has been offering early psychosis programs for much longer, has dramatically cut that time frame to about seven weeks, we continue to lag far behind.
Why? Because youth and young adults first experiencing psychosis are often scared and confused when they suddenly hear voices and see things that aren't really there. Many who seek care have a negative first encounter, don't get what they need and don't go back. Not surprisingly, their condition worsens and becomes much harder to treat. It is alarming for families who face unthinkable stress and who struggle with what to do.
Research has shown that mental illnesses start early in life, yet we are not reaching youth early enough with effective care. This results in high rates of school dropout, unemployment, drug and alcohol abuse, arrest, incarceration and suicide. It takes a tremendous toll on families and communities.
This is especially true for psychosis associated with schizophrenia. But we just got good news from a major multisite study showing that when we identify and effectively treat psychosis early, it is a game changer. The study, Recovery After an Initial Schizophrenia Episode, or RAISE, showed that by delivering the right services at the right time, young people experiencing psychosis get significantly better. They stay in school, in jobs and connected to the social fabric of their lives.
In the study, researchers found that what works is moving beyond crises to identifying psychosis early. What works is taking time to engage youth and supporting families and peers in playing a key role. What works is care that is tailored to each young person's needs and that supports their ability to get better, be successful at school and work and achieve their dreams. What works is giving youth and young adults what they need when they need it to move on with their lives. Hope is the cornerstone of this model of care.
But how do we ensure that young people who experience early psychosis get the right care at the right time? Given the urgency, we certainly need broader public understanding of early psychosis, what works and where to find the services and supports included in the study. The more we talk about and learn about early psychosis, the less likely it will stay hidden until crises hit. Remember when cancer was referred to as the C-word, mentioned only in hushed and whispered tones, if at all? We sure have made progress on that front; time to do the same with the P-word.
The positive outcomes achieved in the study set a new standard of care for early psychosis. Every mental health center in America should be ramping up immediately to deliver that standard of care. Why on earth should we accept anything less? We certainly would not for other serious health conditions like cancer, heart disease or stroke. The costs are far too high.
The National Alliance on Mental Illness began in Madison, Wisconsin, more than 35 years ago with a group of parents, who had had enough with substandard care, lack of progress and being blamed for their adult child's schizophrenia, sitting at a kitchen table together. As a national movement, we are more determined than ever to see that every young person first experiencing psychosis is identified early and connected with effective care. You bet this is a game changer, and we intend to ensure that the game changes for every young person who needs it. We cannot afford to wait.
Originally published in US News & World Report on 11/30/15.
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