What would you do if your teenage son or daughter began expressing paranoid thoughts? Jumbling their sentences? Exhibiting bizarre behavior? Few parents know the warning signs of psychosis, but one joint effort in Connecticut is aiming to change that.
The state’s Department of Mental Health & Addiction Services and Yale University are pioneering MindMap, an outreach program designed to catch the early signs of a young person experiencing a psychotic episode, lessening the chance of self-harm or endangerment to others.
Mindmap’s creation is the result of university psychiatrists discovering that patients who received early treatment at community clinics reduced their risks of future psychotic breaks. Their findings also show that those who get help early on remain employed or in school 92 percent of time, compared to just 67 percent when receiving standard treatment. Even better? Three out of four avoided hospitalizations in the first year (as opposed to half), saving taxpayer dollars.
Patients receiving treatment at Yale’s Specialized Treatment Early in Psychosis (STEP) clinic are set up with a team of caseworkers, which coordinates medication, counseling and social skills training for the patient and education for their family, whose guilt or frustration at the disease can often exacerbate symptoms. (The lack of vital long-term care has been identified as the reason why our mental health system has largely failed after state-run institutions shuttered in the 1960s.)
“Traditionally, people show up to psychiatric care after many years of suffering and poor functioning. Maybe they got psychiatrically committed in a hospital against their will, maybe they were picked up by the police or became homeless,” says STEP clinical director Jessica Pollard. “We try to catch people as soon as they have noticeable symptoms, whether it is full-blown and diagnosable psychosis or signs of something to come.”
Hallucinations, delusions, disorganized speech or excessive motor activity can be caused by, say, stress or substance abuse, but they can also be symptoms of schizophrenia, bipolar disorder or severe depression. And while diagnoses have improved, mental health centers still struggle with the stigmas associated with psychosis.
“People don’t tend to show up on their own for care,” Pollard says. “They’re really embarrassed. They don’t want anyone to know.”
As many as one in every 29 people will experience some form of psychosis — generally defined as losing contact with reality — within their lifetime, according to one study. Psychiatrists know that most people have their first psychotic episode in their late teens or early twenties and reaching people at this early age is key, Yale’s psychiatrists say. It’s when the risk of relapse into psychotic episodes is highest and when two-thirds of suicides triggered by the disease occur.
“The model is a pragmatic, effective and economically feasible,” Vinod Srihari, professor of psychiatry at Yale School of Medicine, says in a statement. “The message is simple,” he adds. “The earlier, the better.”