A collaborative for the early identification and treatment of mental illness with psychosis

FAQ

We have a wealth of resources and general information for clinicians, family and friends, clients, and schools. If you would like more information, please contact us.
 

What is psychosis?

Psychosis occurs when a person loses contact with reality. The word "psychosis" scares some people, but it actually describes an experience that many people have. Three out of every 100 people experience psychosis at some time in their lives, and most of them recover.

What are the symptoms of psychosis?

Psychosis can affect the way a person thinks, feels, and acts. Here are some common symptoms of psychosis:

  • Hallucinations can affect any of the five senses. People experiencing psychosis might see, hear, taste, smell, or feel things that are not there, and they have difficulty believing that their senses are tricking them.
  • Delusions are false beliefs that people hold strongly, despite all evidence that their beliefs are not true. For example, a person experiencing a delusion might believe she is being watched or followed.
  • Confused thinking occurs when a person's thoughts don't make sense. His thoughts can be jumbled together, or they can be too fast or too slow. A person with confused thinking can have a hard time concentrating or remembering anything.
  • Changes in feelings can include quick changes in mood. A person might also feel cut off from the rest of the world, or feel strange in some other way.
  • Behavior changes often result in a person not bathing, dressing, or otherwise caring for herself as usual. Other behavior changes might involve behaviors that don't make sense, such as laughing while someone else is talking about something sad.

Why is early treatment important?

Experiencing symptoms of psychosis may disrupt your life. If psychosis is detected early, many problems can be prevented. The earlier symptoms are treated, the greater the chance of a successful recovery. If symptoms are left untreated, individuals experience greater disruption to their family, friendships, school, and employment. Other problems may also occur or intensify, such as depression, substance abuse, breaking the law, or causing injury to himself/herself. Also, delays in treating symptoms may lead to a slower and less complete recovery. Mental illnesses with psychosis often begin between the ages of 15-25. This is a very critical stage of a young person's life. Adolescents and young adults are just starting to develop their own identity, form lasting relationships, and make plans for their careers and future. Treating symptoms of early psychosis sooner helps individuals live a life of their choosing.

What causes psychosis?

Psychosis could have a number of different causes, and many researchers are working to understand why psychosis occurs. Some popular ideas are:

  • Biological: Some people are more likely to develop psychosis because of their biology or their heredity. Many cases of psychosis have been linked to problems with neurotransmitters, or the chemical messengers that transmit impulses throughout a person's brain and central nervous system. In addition, the relatives of people who experience psychosis are more likely to experience psychosis themselves.
  • Other factors: A person's first episode of psychosis can be triggered by stressful events or by drug use (especially use of marijuana, speed, or LSD).

What are the phases of psychosis?

Psychosis occurs in three predictable phases, but the length of each phase varies from person to person. These phases are:

  1. The prodromal phase is the early warning phase of psychosis when a person experiences some mild symptoms and vague signs that something is not quite right.
  2. During the acute phase, a person clearly experiences one or more of the symptoms of psychosis.
  3. When a person reaches the recovery phase, he begins to feel like himself again. Different people experience the recovery phase differently. With effective treatment, many people who reach the recovery phase may never experience psychosis again.

How is psychosis treated?

Most people recover from psychosis, and many do so with the help of treatment. This treatment usually includes several parts:

  • Learning treatment options and working with professionals to determine which options are right for you.
  • Working with a mental health professional to practice ways to cope when things feel bad.
  • Working with a doctor to determine how medications can help.
  • Working with professionals who specialize in helping individuals learn to manage everything from relationships to jobs and school.

Do people recover from psychosis?

Three out of every 100 people experience psychosis at some time in their lives, and most of them recover. Recovery from psychosis results in some important life changes, and there are several things people can do to help themselves recover from psychosis.

What is it like to recover from psychosis?

Different people have different stories to tell about their recovery from psychosis. For example, some recover very quickly, while others only feel better after several months. With treatment, support and hard work, people in recovery from psychosis can look forward to their lives improving in some important ways.

What helps people recover from psychosis?

The most important thing that helps people recover from psychosis is getting active. It may sound strange, but passively sitting around waiting for medicine and the professionals to cure you is usually not the way recovery happens! Most people who recover get active by:

  • Participating in treatment: Active treatment participants partner with their treatment providers to learn all they can about their treatment options, such as medications and therapy. They keep their appointments with these providers and give the providers honest feedback about how treatment is working or not working for them.
  • Focus on personal goals: Personal goals in work, school, or other areas of life can be strong motivators for people recovering from psychosis. If they are not immediately ready to resume all their previous activities, people recovering from psychosis can set smaller, more realistic goals that will help them make progress.
  • Finding needed support: Friends, family, and other important people can provide important encouragement as people recover from psychosis. In addition, support groups for people who are recovering from psychosis can be important. In a support group you can find hope, friends, pride, and proven strategies for getting well.
  • Taking care of yourself: Recovering from psychosis is hard work, so people recovering from psychosis must make sure they take good care of themselves. This means they need good diets, plenty of exercise and sleep, and regular medical check-ups.
  • Taking an honest look at drug and alcohol use: For some people, drug and alcohol use can trigger psychosis or make it worse. It can really help to take an honest look at your drug or alcohol use and ask yourself, "Has it contributed to my psychosis?"
  • Keep your time structured: Many people find that being bored is stressful. Just hanging around doing nothing is usually not helpful. Get busy and structure your day with activities such as school, work, volunteering, friends and exercise. Try to find the right balance between time alone and with time around people.

(Developed as part of the National Institute of Mental Health's Recovery After an Initial Schizophrenia Episode – Implementation and Evaluation Study)

 

 

For Clinicians

Recent scientific advances in the treatment of mental disorders characterized by psychosis support a paradigm shift in the way that treatment is provided. Rather than wait to treat until a disorder is established, the new framework involves early detection and intervention with young people who are at clinical high risk for, or who are in the initial stages of, a mental disorder with psychosis. The clinical high risk state is associated with distress, compromised social and instrumental role function, and has been extensively validated with cognitive and structural and functional neuroimaging data. Further, a significant portion of these individuals will transition to a mental illness with psychosis over time. Similarly, for many young people just beginning to experience a mental disorder with psychosis, the process of correctly identifying and diagnosing what is going on and what types of treatments are best can follow months or years of misdiagnosis in which mental health problems go untreated and young people and their families experience substantial stress and uncertainty. Research shows that the longer a mental disorder with psychosis goes untreated, the more vulnerable a young person is to experiencing increased illness and symptom severity, poorer functioning, lower employment rates, higher rates of substance use and abuse, and greater disability.

In light of the high costs of delayed treatment, early diagnosis and intervention are crucial mental health needs for young people with, or at clinical high risk for, mental disorders with psychosis. As a result, there is a rigorous effort, both nationally and worldwide, to develop and implement specialty care intervention programs designed to identify young people at risk for developing or who are in the early stages of experiencing these mental health disorders and to immediately engage them and their families in care. Prevention and early intervention are associated with greater improvements in symptoms, school and work performance, interpersonal relationships, health, and attainment of recovery goals. Overall, the goal of early identification and treatment of young people at clinical high risk for, or in the early stages of, mental disorders with psychosis is to alter the course of illness, reduce disability, and maximize recovery.

The Maryland Early Intervention Program (EIP) will be a specialized program with expertise in the early identification, evaluation, and treatment of adolescents and young adults who are at clinical high risk for, or in the early stages of, a mental disorder with psychosis. The EIP will include four components: 1) Outreach and Education Services; 2) Clinical Services; 3) Consultation Services; and 4) Training and Implementation Support Services. Research will be integrated into each of these components and will focus on using objective methods for early detection and prediction of disease emergence, progress, or recovery. These tools will then be used to guide intervention refinement to enhance efficacy and effectiveness. The EIP will take an integrated approach to addressing the health and mental health needs of young adults, including providing support for co-occurring substance use disorders, metabolic risks, and other co-occurring medical conditions. Overall, the EIP is committed to reducing disability by equipping young people and their families with tools to manage their illness, move successfully through the developmental stages of growth, and establish a life of their choosing. 

The EIP is a collaboration among several centers and divisions within the University of Maryland (UM) School of Medicine Department of Psychiatry, including the Maryland Psychiatric Research Center and the Divisions of Child and Adolescent Psychiatry, Community Psychiatry, Psychology and Psychiatric Services Research, and the University of Maryland Baltimore County Department of Psychology. The partners have extensive experience providing clinical services to the citizens of Maryland, evaluating novel therapeutics for people with treatment-resistant schizophrenia, implementing statewide program evaluation relating to serious mental illness in youth, and providing consultation services for adverse effects of first- and second-generation antipsychotic drugs. At the outset, core personnel and facilities will be provided through the UMSOM Department of Psychiatry and UMBC Department of Psychology. Over time, we will develop a comprehensive, statewide program with clinical services provided both by these UM centers and divisions, as well as by satellite sites across the state. All EIP activities will be guided by a multi-disciplinary Advisory Council, including youth, family, and consumer advocacy membership.

For Family and Friends

What is the role of family and friends in recovery from psychosis?

Family members and friends can be extremely important in the recovery process. The person may have difficulty in the early period with many things which used to be easy for them. When a person is recovering from their psychotic episode you can provide love, stability, understanding and reassurance, as well as help with practical issues. There are many ways that family members can help a person in recovery from psychosis. Family members and friends can:

  • Help the person with psychosis get to treatment appointments and work with their treatment team.
  • Stay in regular contact with the treatment team.
  • Advocate for the person with psychosis to get the support he/she needs.
  • Learn about psychosis so you know what is happening.
  • Assist with remembering and initiating appointments and activities.
  • Observe and report symptoms the person with psychosis may not be aware of.
  • Include the person with psychosis in family and social activities.
  • Maintain a safe, positive, supportive atmosphere at home and when socializing.
  • Help with finances.
  • Take care of yourself and get your questions answered.
  • Understand the goals that your loved one has for recovery.
  • Be patient.
  • Attend family support groups in your area to learn how other families cope and support the recovery of loved ones.

For Clients

For Youth and Young Adults 

The Teen Brain: Still Under Construction (NIH 11-4929)
Studying the development of the brain, research has revealed that striking changes take place during the teen years. This brochure explains these changes and other keys to the adolescent brain. (1 p.)

Depression and College Students: Answers to College Students' Frequently Asked Questions About Depression (NIH 12-4266)
Many people experience the first symptoms of depression during their college years. This booklet describes what depression is, how it affects college students, and treatment options. (7 p.)

Depression and High School Students: Answers to Students’ Frequently Asked Questions About Depression (OM 12-4302)
This brochure provides answers to students frequently asked questions about depression including what it is, how it is treated, and how to help a friend. 
(1 p.)

Voices of Recovery

Click on any of images below the watch testimonial videos from individuals living with mental illness. These videos were created as part of the RAISE Connection Program with funding from the National Institute of Mental Health.

 

Ryan  Ryan Ryan  Corey  Corey   Corey  
         
Fulfilling My Dream Turning
Points 

 Finding Inspiration:
Power of Peer Support 

 Tools for
Getting Better 
 One Door Closes,
Another Opens 
 When I Wanted to
Get Sober 
           
 Francisco  Melissa  Melissa  Raquea  Linda  Linda
           
 How A Treatment
Team Can Help 
 Working  Dealing With Paranoia  Finding What
Works 
 Finding Supports: 
A Parent's Story 
 Advice From
A Parent
           
 Sherri  Sherri  Tina  Tina  Tina  Tina
           
 You Are Worth It  Learning What Helps  Clearing My Mind  Living My
Everyday Life 
 Making Yourself
Heard 
 Managing My
Anger
           
Patrick Patrick William William Barbara Barbara
           
 Reconnecting With
Friends 
 Getting Active  Managing My
Recovery
 Knowing What
It's Like 
 When My Son
Became Ill 
 Understanding My
Son's Illness 

Additional Resources

General Resources

Active Minds

American Psychiatric Association's Healthy Minds Blog

EASA and FEMHC Program Directory of Early Psychosis Intervention Programs (2016)

Maryland Coalition of Families

Mental Health America

National Alliance on Mental Illness

National Association of State Mental Health Program Directors-Early Intervention in Psychosis

Partners for Strong Minds (Formerly: National Psychosis Prevention Council)

 

Maryland EIP Facebook Page

Visit the official Maryland EIP Facebook page and "Like" so you can stay informed about EIP

 

Resources for Families

Children's Mental Health Matters! Family Resource Kit*

Fact sheets about 1) common behaviors or diagnoses children and teens may experience & 2) when and where to find professional help if you suspect your child has a mental health disorder. *In partnership with the Maryland Coalition of Families for Children's Mental Health and the Mental Health Association of Maryland

 

NAMI Family to Family

A free 12-week educational course for family, caregivers, and friends of individuals with mental illness

Contact information: (800) 950-NAMI (6264) or Click Here

Click Here for other groups available

 

Black Mental Health Alliance

Promotes a holistic, culturally relevant approach to developing and maintaining mental health programs and services for African Americans and other people of color

Contact information: Phone (410) 338-BMHA (2642); Fax (410) 338-1771;  Or visit their website

733 West 40th Street, Suite 10

Baltimore, MD 21211

 

Crisis Resources

Youth Crisis Hotline for all of Maryland: (800) 422-0009 (operates 24/7)

The Family Tree: Parent Stress Line (Formerly Parents Anonymous of Maryland): (800) 243-7337 (24-hour stress line)

Baltimore Crisis Response Inc.: (410) 433-5175

Baltimore City

Baltimore Child and Adolescent Response System (BCARS): (410) 727-4800 or visit their website

First Step Youth Services Center: Hotline (410) 521-3800

Baltimore Crisis Response Hotline: (410) 752-2272

Baltimore County

Baltimore County Crisis Team/Hotline: (410) 931-2214

 

Substance Use and Mental Health Resources

National Council on Alcoholism and Drug Dependence, Inc.

National Institute on Drug Abuse (NIDA)

NIDA for Teens

Substance Abuse and Mental Health Services Administration (SAMHSA)

Treatment Centers in Maryland

EPOCH Counseling Center (Baltimore County) and Resources

Harbel Prevention and Recovery (Baltimore City)

Mountain Manor Treatment Center (Locations throughout Maryland)

Maryland Drug Rehabs

 

Information Resources from the National Institute of Mental Health (NIMH)

Treatment

Treatment of Children with Mental Illness: Frequently Asked Questions About the Treatment of Mental Illness in Children (NIH 11-4702) Answers to frequently asked questions about the treatment of mental illness in children. (6 p.)

Mental Health Medications (NIH 12-3929) This guide describes the types of medications used to treat mental disorders, side effects of medications, directions for taking medications, and any FDA warnings. (30 p.)


Safety and Violence

Suicide in America: Frequently Asked Questions (TR 11-7697) A brief overview of the statistics on depression and suicide with information on depression treatments and suicide prevention. (1 p.)

Suicide: A Major, Preventable Mental Health Problem - Facts About Suicide and Suicide Prevention Among Teens and Young Adults (OM 12-4303) This brochure answers some common questions about suicide. Learn what some of the risk factors are and how to look for signs. (1 p.)

Helping Children and Adolescents Cope with Violence and Disasters: What Rescue Workers Can Do (NIH 12-3520) A brochure that describes what rescue workers can do to help children and adolescents cope with violence and disasters. (1 p.)

Helping Children and Adolescents Cope with Violence and Disasters: What Parents Can Do (NIH 13-3518) A brochure that describes what parents can do to help children and adolescents cope with violence and disasters. (1 p)


Related Diagnoses 

Schizophrenia (NIH 10-3517) A detailed booklet on schizophrenia that describes symptoms, causes, and treatments, with information on getting help and coping. (18 p.)

Anxiety Disorders An interactive link that describes the symptoms, causes, and treatments of the major anxiety disorders, with information on getting help and coping. 

Bipolar Disorder in Adults (NIH 12-3679) A detailed booklet that describes bipolar disorder symptoms, causes, and treatments, with information on getting help and coping. (32 p.)

Bipolar Disorder in Children and Adolescents (NIH 12-6380) This booklet is for parents who think their child may have symptoms of bipolar disorder, or parents whose child has been diagnosed. (28 p.)

Bipolar Disorder in Children and Teens (QF 11-6380) A brochure on bipolar disorder in children and teens that explains what it is, when it starts, and how to get help. (1 p.)

Depression (NIH 11-3561) A detailed booklet that describes depression symptoms, causes, and treatments, with information on getting help and coping. (24 p.)

Depression and College Students: Answers to College Students' Frequently Asked Questions About Depression (NIH 12-4266) Many people experience the first symptoms of depression during their college years. This booklet describes what depression is, how it affects college students, and treatment options. (7 p.)

Depression and High School Students: Answers to Students’ Frequently Asked Questions About Depression (OM 12-4302) This brochure provides answers to students' frequently asked questions about depression including what it is, how it is treated, and how to help a friend. (1 p.)

Generalized Anxiety Disorder: When Worry Gets Out of Control (TR 13-4677) A brochure on generalized anxiety disorder that explains what it is, when it starts, and how to get help. (1 p.)

Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over (TR 13-4676) A brochure on obsessive-compulsive disorder that explains what it is, when it starts, and how to get help. (1 p.)

Panic Disorder: When Fear Overwhelms (TR 13-4679) A brochure on panic disorder that explains what it is, when it starts, and how to get help. (1 p.)

Post-Traumatic Stress Disorder (PTSD) (NIH 10-6388) A booklet on post-traumatic stress disorder (PTSD) that explains what it is, treatment options, and how to get help. (14 p.)

Postpartum Depression Facts (NIH 13-8000) A brochure on postpartum depression that explains its causes, symptoms, treatments, and how to get help. (1.p)

Social Phobia (Social Anxiety Disorder): Always Embarrassed (TR 13-4678) A brochure on social phobia (social anxiety disorder) that explains what it is, when it starts, and how to get help. (1 p.)