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Description: You are no doubt aware of the standard medical observation that the earlier an emerging health challenge is identified the more effectively it can be treated or even prevented from fully emerging. There is also a lot of talk about the sorts of things one can do to contribute positively to one’s mental health (e.g., managing stress, being mindful, focusing on positive coping strategies, maintaining social support connections, etc.). What you likely have not heard, because it is not being discussed very much, are ways in which we might used early detection and early intervention as ways of warding off the advancement Serious mental disorders like schizophrenia. The idea makes sense but the challenge is that the early stages of the onset of schizophrenia are most likely to occur in late adolescence or in emerging adulthood (18 to 25 years-of-age) and that means that the signs to look for are often confused with things that are normatively a part of adolescence. If you were asked to design a program to look for early signs of psychosis (a symptom of schizophrenia) and to follow up with early interventions what would it involve and what challenges would you have to overcome? After you have your thoughts in order have a read through the article linked below that describes a rather well designed version of such a program.

Source: Interventions to Prevent Psychosis, Jane E. Brody, Personal Health, The New York Times.

Date: September 2, 2019

Image Credit: Gracia Lam, The New York Times

Article Link:  

You have likely heard a fair bit lately about the issue of stigma associated with mental health, but it is important to also notice that stigma can also make it less likely that we may consider the early signs of psychosis as what they are. The early signs of psychosis are listed in the article and are well worth keeping in mind so that the pattern will be something you consider when it may apply to a friend or relative. The prevention data discussed in the article are particularly encouraging as is the broad, multidisciplinary nature of the Pier program. As the program developer points out, “this isn’t about drug treatment.” The 75% effectiveness associated with early intervention when compared to the 25% effectiveness when the program is applied later point to the importance of finding and exploiting the early intervention window of opportunity. This is something we can all work on.

Questions for Discussion:

  1. What are the early warning signs of psychosis?
  2. How might issues of stigma associated with mental illness make implementing an effective early identification and intervention program for psychosis difficult?
  3. What are some things that school, colleges and universities and the staff and students within them do to advance the awareness and availability of early identification and intervention programs for psychosis?

References (Read Further):

National Alliance on Mental Illness – NAMI (2019) – Know the Common Warning Signs of Mental Illness.

van der Gaag, M., Smit, F., Bechdolf, A., French, P., Linszen, D. H., Yung, A. R., … & Cuijpers, P. (2013). Preventing a first episode of psychosis: meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophrenia research, 149(1-3), 56-62.

Oliver, D., Davies, C., Crossland, G., Lim, S., Gifford, G., McGuire, P., & Fusar-Poli, P. (2018). Can we reduce the duration of untreated psychosis? A systematic review and meta-analysis of controlled interventional studies. Schizophrenia bulletin, 44(6), 1362-1372.

Woodberry, K. A., Seidman, L. J., Bryant, C., Addington, J., Bearden, C. E., Cadenhead, K. S., … & Perkins, D. O. (2018). Treatment precedes positive symptoms in North American adolescent and young adult clinical high risk cohort. Journal of Clinical Child & Adolescent Psychology, 47(1), 69-78.

McFarlane, W. R., Levin, B., Travis, L., Lucas, F. L., Lynch, S., Verdi, M., … & Cornblatt, B. (2014). Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. Schizophrenia bulletin, 41(1), 30-43.