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Youth First

UMBC researchers collaborate to treat and prevent psychosis in young people.

A teenager thinks someone is following him when no one is there. Another believes the television is sending her special hidden messages and feels disoriented by time speeding past. These represent symptoms of psychosis, a mental illness comprised of hallucinations and delusions.

What can be done to treat and prevent psychosis in young adults to help them get back on track to leading the lives they want to live? Psychology associate professor Jason Schiffman and his Youth First research team are trying to answer this question in partnership with leading psychosis intervention experts.

The Maryland General Assembly approved funding this year to establish the Center for Excellence on Early Intervention for Serious Mental Illness. This collaborative program aims to treat young people between the ages of 12 and 22 who are showing early warning signs of developing psychosis.

Jointly with the University of Maryland Medical Center, University of Maryland School of Medicine, and Maryland Psychiatric Research Center, Schiffman and his team of graduate and undergraduate students are studying factors that put young people at risk for developing psychosis. They are in the early stages of also providing clients with youth-focused and family-centered assessment and treatment.

“An ounce of prevention is worth a pound of medicine,” Schiffman says. “If we find young folks who might be on a trajectory towards risk for more severe mental health concerns and we intervene with them early, then we might be able to provide them the best opportunities to lead the lives that they want to lead.”

Schiffman is heading the clinical high-risk program at the new center. A major emphasis at this stage of the clinic’s development is outreach, working with community partners and stakeholders to educate the public about warning signs and the value of early intervention and prevention.

As the center grows, Schiffman will increasingly focus on assessment and clinical treatment of individuals exhibiting hallucinations and delusions that may turn into psychotic behavior. He and his collaborators will combine resources from partner institutions to design unique treatment programs suited to patients’ individual needs, which take into account their experiences as young adults.

“Psychosis sometimes isn’t the main thing that folks want help with,” Schiffman observes. “We may be working, for instance, with a young person who hears voices, but his priority may not be the voices per se. It may be making friends, doing well in school, graduating, getting a job...we want to be equipped to be able to manage those priorities.”

When intervention responds to the individual’s needs and happens very early on, it can be instrumental in preventing violence, Schiffman argues.

Several recent tragedies have been linked to mental illness. But part of what Schiffman and his team are trying to emphasize is that people with psychosis are far more likely to be victims of violent acts than to carry them out.

“Additionally, the risk of suicide and self-inflicted violence is incredibly high. One in five individuals who is in their early episode or first episode of psychosis is likely to attempt suicide,” Schiffman says. “One in twenty will complete that suicide.”

Patient assessments have already begun through the facilities of clinic partners, and Schiffman is hopeful his team can begin clinical treatment in the spring. The new center is something larger than anyone of the participants could have created on their own. For UMBC, this collaboration means greater training opportunities for students interested in psychiatric medicine and social work, including the ten remarkable UMBC graduate students on the Youth First team: Eryn Bentley, Elizabeth Connors, Caroline Demro, Danielle Denenny, Greg Epstein, Sabrina Ereshefsky, Emily Kline, Elizabeth Thompson, Thomas Tsuji, and Camille Wilson. For the community, the impact is palpable in a different way.

“If we can reduce their suffering as a function of some of the symptoms that come along with this disorder, if we could even prevent illness in and of itself, we’d be making a huge difference for [youth with psychosis], for their family and loved ones, for their friends, and for a wider community that may or may not even know they were at risk.”

Schiffman has been featured in USA Today and The Baltimore Sun, and was also a guest on WYPR’s Maryland Morning discussing his role in the new center.

(12/09/2013)