1. Psychosis: Early Identification and Intervention Easter Seals Michigan

2. Did you know… Approximately 100,000 youth and young adults experience an episode of psychosis each year—that’s 274 young people each day. The duration of untreated psychosis in the US is 1-2 years. Systems of care wait for illness. 3X as many young people who have experienced psychosis will drop out of school as compared to their peers.

3. Did you know… The highest risk of violence at the hands of someone with psychosis is suicide. At least 10% of people who experience schizophrenia will die by suicide as compared to 1% for the general population. The World Health Organization ranks psychosis as the 3 rd most disabling condition in the world.

4. Did you know… While 77% of those experiencing first episode psychosis will have a remission of symptoms with medication, 2/3 of those individuals will experience no functional recovery (social, school, work).

5. All of this means that there are young people in every high school, on every college campus, in every community struggling with the early symptoms of psychotic illness.

6. The costs of delaying treatment are high…

7. BIOLOGICAL IMPACT Exacerbated impact of psychosis Reduced rate and level of recovery Risks of worse physical health

8. PSYCHOLOGICAL IMPACT Despair Demoralization Loss of confidence in self Depression & suicide Disrupted personality development Anxiety, social phobia, PTSD

9. SOCIAL IMPACT Disruption to interpersonal relationships Disruption to education or employment Isolation from families and friends Impact on the family Increased unemployment Involvement in risky behaviors Risks associated with homelessness Risk of victimization Increased risk of legal problems

10. The Good News… A growing body of research demonstrates that early identification and an integrated treatment model consisting of the following supports can put recovery within reach: low-dose medication strengths based individual treatment with illness management skills focus family education and support supported employment and education

11. Benefits of Early Intervention Less treatment resistance and lower risk of relapse Reduced risk for suicide Reduced disruptions to work or school attendance Retention of social skills and support Decreased need for hospitalization More rapid recovery and better prognosis Reduced family disruption and distress

12. Coordinated Specialty Care program that was part of the RAISE (Recovery After An Initial Schizophrenia Episode) research endeavor. Now being offered at three sites in Michigan as part of the SAMHSA 5% set aside block grant funding for early intervention in first episode psychosis.

13. Michigan Sites ETCH: Early Treatment and Cognitive Health –East Lansing, MI Interact of Michigan –Grand Rapids, MI Easter Seals Michigan –Southfield, MI

14. Program Components SEE Prescriber IRT Family

15. Program Components Pharmacological Management Family Program Supported Employment and Education (SEE) Individual Resiliency Training (IRT)

16. Pharmacological Management Medication strategies available to assist the Prescriber in treating early phase clients Striving for lowest possible effective dose Use of a questionnaire to monitor client adherence, symptoms, and side effects Assessment of physical factors such as weight and BMI is an important component

17. Family Program Provides family (including client) with education about psychosis, coping strategies, skills for communicating and solving problems Goals of the program: –Shore up family relationships for the long haul –Change the trajectory of the illness by supporting resumption of role functioning and social pursuits –Reduce stress and burden in family members

18. Supported Employment and Education (SEE) The goal of SEE is to help people develop and achieve personally meaningful goals related to their careers, their education and their employment SEE services are individualized for each person based on their preferences, goals, and values SEE services are provided based on the person’s choice to pursue employment, or education, or both Different from vocational counseling Vast majority of services takes place OUTSIDE THE OFFICE

19. Individual Resiliency Training (IRT) Goal is to promote recovery by identifying client’s strengths and enhancing illness self management skills –Assists clients in learning about psychosis, processing their experience of psychosis, developing relapse plan, increasing resiliency, learning specific strategies and skills to achieve own personal goals; IRT clinician may also provide case management –Weekly or twice a month sessions until standard and selected individualized modules are completed

20. Program Eligibility 15-30 years of age Schizophrenia Spectrum Disorder Diagnosis: –Psychosis NOS –Schizophreniform –Schizophrenia –Schizoaffective (rule out substance induced psychosis) 18 months or less of illness Live in Oakland County No insurance requirement

21. Everyone desires an equal opportunity to chase their dreams.

22. Referral Process For additional information or to submit a referral, Contact Heidi Ret, Project Director 248-372-6882 OR hret@essmichigan.org

23. Resources RAISE Study Overview: http://www.nimh.nih.gov/health/topics/schiz ophrenia/raise/coordinated-specialty-care- for-first-episode-psychosis-resources.shtml http://www.nimh.nih.gov/health/topics/schiz ophrenia/raise/coordinated-specialty-care- for-first-episode-psychosis-resources.shtml National Psychosis Prevention Council: http://psychosisprevention.org/ http://psychosisprevention.org/