Early and First-Episode Psychosis – What is it and how should it be treated?
Psychosis temporarily interferes with the brain’s ability to make out reality and causes disruptions in thoughts and perceptions. Everyone’s experience with psychosis is different. Psychosis often comes and goes in episodes. It is more common than most people think; it affects about 3 in 100 people during their lives.
Early psychosis, also known as first-episode psychosis (FEP), is often frightening, confusing and distressing for the person experiencing it and difficult for his or her family to understand.
Know the Signs:
- Hearing, seeing, tasting or believing things that others don’t
- Suspiciousness or extreme uneasiness with others
- Persistent, unusual thoughts or beliefs
- Strong and inappropriate emotions or no emotions at all
- Withdrawing from family or friends
- A sudden decline in self-care
- Trouble thinking clearly or concentrating
These warning signs may signal early psychosis. If you or someone you know is experiencing these warning signs, contact a healthcare professional. Early action keeps young lives on track. Local programs for evaluation and treatment of early psychosis include:
- Penn Psychosis and Evaluation and Recovery Center at Penn Medical School (http://www.med.upenn.edu/bbl/penn-perc.html)
- Psychosis Education, Assessment, Care, and Empowerment at Horizon House (http://phillypeace.org/).
- First Episode Psychosis Program at Child & Family Focus (https://namipamainline.org/wp-content/uploads/2017/01/First-Episode-Psychosis-Flyer.pdf)
Early diagnosis and treatment provide the best hope for recovery. The most effective treatment for early psychosis is Coordinated Specialty Care (CSC). The earlier a person experiencing psychosis receives CSC, the better his or her quality of life. CSC uses a team-based approach with shared decision-making that focuses on working with individuals to reach their recovery goals. Programs that provide CSC are often called first-episode psychosis or FEP programs. These programs are available in a growing number of areas.
Key Components of CSC include:
- Case management—working with the individual to develop problem-solving skills, manage medication and coordinate services
- Family support and education—giving families information and skills to support their loved one’s treatment and recovery
- Psychotherapy—learning to focus on resiliency, managing the condition, promoting wellness and developing coping skills
- Medication management—finding the best medication at the lowest possible dose
- Supported education and employment— providing support to continue or return to school or work
- Peer support—connecting the person with others who have been through similar experiences.
Research shows that CSC is cost effective, and that clients feel that the CSC treatment is helping them. Researchers also found that CSC is more effective than usual treatment approaches, and that CSC is most effective when the client has a shorter duration of untreated psychosis,
A mother’s experience and advocacy for CSC is summarized in “Building a Movement for Better Early Psychosis Care” (http://www.nami.org/Blogs/NAMI-Blog/November-2016/Building-a-Movement-for-Better-Early-Psychosis-Car?utm_source=naminow&utm_medium=email&utm_campaign=naminow).
Back to School: Toolkits to Support the Full Inclusion of Students with Early Psychosis in Higher Education provides advice for students and family members (http://bit.ly/2vnBspW).
Advice for College Students with Mental Health Issues: https://www.nami.org/collegeguide/download
 Much of this information is excerpted from http://www.nami.org/getattachment/Learn-More/Mental-Health-Conditions/Early-Psychosis-and-Psychosis/NAMI-Early-Psychosis.pdf and https://www.nimh.nih.gov/health/topics/schizophrenia/raise/what-is-raise.shtml. Additional information is available at https://www.nami.org/Blogs/NAMI-Blog/March-2017/Understanding-Psychotic-Breaks and https://www.nami.org/Blogs/NAMI-Blog/March-2017/How-Should-We-Be-Treating-First-Episode-Psychosis.