Welcome to the Maryland Early Intervention Program (EIP) Resources page! We have a wealth of resources and general information here related to early psychosis, in addition to specific information for providers, schools, family and friends, and clients and consumers. Some of the key areas that we have highlighted include: Evidence-Based Treatments, Supported Employment, Prescribing, Young People and Families, and Stigma Reduction. Please click the tabs above to view each of these specific areas. If you have questions or would like more information, please see the contact information in each tab or contact us at the EIP main office.
You can also access more than 20 free early psychosis webinars and free downloadable implementation materials at our partner website, www.MDBehavioralHealth.com.
Early intervention with evidence-based treatments for individuals experiencing a first episode of psychosis (FEP) provides the best chance for clinical and functional recovery.
Coordinated Specialty Care (CSC) is a model of FEP treatment that incorporates evidence-based treatments. CSC emphasizes team-based and recovery-oriented care.
Below, you can find various resources and treatment manuals to use in your FEP clinical work. Further consultation is available through the Maryland EIP from Melanie Bennett, Ph.D. (firstname.lastname@example.org).
Frequently Asked Questions (Developed as part of the National Institute of Mental Health's Recovery After an Initial Schizophrenia Episode – Implementation and Evaluation Study)
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. Psychosis can affect the way a person thinks, feels, and acts. Here are some common symptoms of psychosis:
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:
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:
How is psychosis treated? Most people recover from psychosis, and many do so with the help of treatment. This treatment usually includes several parts:
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:
IEPA Early Intervention in Mental Health. IEPA Early Intervention in Mental Health is a non-profit international network for those involved in the study and treatment of the early phases of mental health disorders encompassing a trans-diagnostic approach. IEPA aims to enhance awareness of the early phases of mental health disorders more generally, their causes, prevention and the process of recovery. A key part of our mission is to improve access to information on the identification and treatment of mental ill health in its early phases and provide links to existing educational resources and training options.
SAMHSA’s FEP and Co-Occurring Substance Use Disorders Guide. This free guide supports health care providers, systems, and communities to address first-episode psychosis and co-occurring substance use disorders. It describes relevant research, examines emerging and best practices, identifies knowledge gaps and implementation challenges, and offers resources.
Understanding a First Episode of Psychosis. Caregiver: Get the Facts. This handout provides an easy-to-understand review of early psychosis and its treatments.
General Resources on Evidence-Based Early Psychosis Treatment
NAVIGATE. NAVIGATE is a comprehensive program designed to provide early and effective treatment to individuals who have experienced a first episode of psychosis. It was developed with support from NIMH and has been implemented at 20 sites throughout the U.S. and one in Canada, including urban, suburban, and rural settings, and has provided treatment to people from diverse ethnic and cultural backgrounds. NAVIGATE is one of the options for implementing Coordinated Specialty Care (CSC) for early psychosis. The NAVIGATE website provides treatment manuals and other web-based resources as well as information on working with the NAVIGATE team on training and consultation.
OnTrackNY. OnTrackNY is an innovative treatment program for adolescents and young adults who have had unusual thoughts and behaviors or who have started hearing or seeing things that others don’t. OnTrackNY helps people achieve their goals for school, work, and relationships. Programs are located throughout New York State. The OnTrack website provides treatment manuals and resources for young adults, families, and clinicians. They also provide an interactive tool to estimate costs and staffing for CSC teams.
OnTrackUSA – Center for Practice Innovations. OnTrackUSA helps to implement CSC teams that provide innovative, evidence-based, recovery-oriented treatment to young people who have recently begun experiencing psychotic symptoms. These teams help people achieve their goals for school, work and relationships. We provide manuals and other web-based resources as well as consultation and training to programs and State agencies that would like to implement Coordinated Specialty Care teams (CSCs) for people with early psychosis.
National Association of State Mental Health Program Directors (NASMHPD). The NASMHPD provides descriptions and links to various clinician manuals, programmatic descriptions and guidelines, and other tools developed to support quality care for persons in early stages of psychosis.
National Alliance on Mental Illness (NAMI). NAMI is the United States’ largest grassroots non-profit mental health organization. Their website provides information for young adults on families on early psychosis signs, treatment, and recovery. They also offer programs that provide support to individuals and families as they seek services, make treatment decisions, and manage their mental health recovery.
SMI Adviser. SMI Adviser is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by the American Psychiatric Association (APA). SMI Adviser provides education, data, and consultation to providers.
Locating CSC Services
If you are looking for services in Maryland, please see our Clinic Locations.
SAMHSA Early SMI Treatment Locator. The Early Serious Mental Illness Treatment Locator is a confidential and anonymous source of information for persons and their family members who are seeking treatment facilities in the United States or U.S. Territories for a recent onset of serious mental illnesses such as psychosis, schizophrenia, bi-polar disorder and other conditions. These evidence-based programs provide medication, therapy, family and peer support, assistance with education and employment and other services.
National Early Psychosis Directory. This directory is provided by the Early Assessment and Support Alliance. It provides a spreadsheet to find contact information for early psychosis programs across the United States.
The Prodrome and Early Psychosis Program Network (PEPPNET). This network is provided by Stanford University. PEPPNET's mission is to support the national network of programs providing services to those at risk for or experiencing early psychosis by promoting communication, collaboration, and best practices so that individuals and families experiencing early psychosis have timely access to specialized, appropriate, and affordable care.
La CLAve. La CLAve is a public outreach campaign that targets the Latino population in various regions of California to help families identify the symptoms of serious mental illness and assist them in seeking services for early treatment. La CLAve has partnered with various community and health organizations in Pacoima, San Fernando, Sylmar, Panorama City, North Hills, Sun Valley, and Kern County, and is always looking to partner with more locations to help those in need obtain early treatment for serious mental illness.
University of Washington Department of Psychiatry and Behavioral Sciences Evidence-Based Practices for Adults. This website provides resources for consumers and families that provide information on treatment for early psychosis in Washington State and in other states.
Psychosis Screening Resources
Strive for Wellness. The Strive for Wellness (SFW) Clinic delivers early identification and intervention services to individuals age 14-25 with psychosis or who are potentially at risk to develop psychosis. Providers, families, and consumers can access and complete a free early psychosis screening tool at the SFW website linked above.
Psychosis Screening in Primary Care. This is an informational tool produced by early SMI clinicians and researchers in Boston (via Boston Children’s Hospital, the Massachusetts Department of Mental Health, and the Beth Israel Deaconess Medical Center and Harvard Medical School Departments of Psychiatry). This website was designed to help providers working with teens and young adults to know the signs of early psychosis, provide assessment, and find appropriate treatment resources. This site has a Resources tab for providers, patients and families, and for mental health referrals.
Resources on Prescribing in First-Episode Psychosis
The 2009 Schizophrenia PORT Psychopharmacological Treatment Recommendations and Summary Statements. This article describes a literature review and update of psychopharmacological treatment recommendations for the treatment of schizophrenia.
NIMH Press Release on Prescribing for Patients with First Episode Psychosis. This press release describes a study that found that many young people with first-episode psychosis in community mental health clinics across the country might benefit from medication treatment changes.
Medications for First-Episode Psychosis: Making a Good Start. This article provides an introduction to a special issue of Psychiatric Services dedicated to research on prescribing for patients with first episode psychosis.
Optimizing Medication Management for Persons with First Episode Psychosis. This brochure from the National Association of State Mental Health Program Directors provides a shared decision-making tool that young people can use in collaboration with their psychiatrist or other professionals that prescribe medication. It also provides a chart that lists the side effects across a range of medications and a first-person account of some key lessons learned when reducing psychotropic medication.
OnTrackUSA – Center for Practice Innovations. OnTrackUSA provides first-person video accounts of experiences using medication and coping with side effects. It also provides a worksheet for consumers and families to use in making decisions about using long acting injectable antipsychotic medications.
Resources for Learning Evidence-Based Practices
Illness Management and Recovery (IMR). IMR is an evidence-based practice for adults with SMI. IMR practitioner guides and handouts can be found here within the IMR manual (361 pages). IMR includes an orientation and covers ten topics (recovery strategies; practical facts about mental illness; stress-vulnerability model and treatment strategies; building social support; using medication effectively; drug and alcohol use; reducing relapses; coping with stress; coping with problems and persistent symptoms; getting your needs met by the mental health system)
Social Skills Training for Schizophrenia. This website provides a range of SST training resources. Social Skills Training for Serious Mental Illness (SST) is an evidence-based practice for persons with schizophrenia (Dixon et al., 2010). SST is also commonly used effectively with people with other types of serious mental illness (SMI). The social skills model used is based on Social Skills Training for Schizophrenia: A Step-by-Step Guide (Bellack, Mueser, Gingerich, & Agresta, 2004). SST is a treatment procedure that has been developed to enhance interpersonal skills with the goal of improving community adjustment, quality of life and pursuit of personal goals. SST involves an initial individual session followed by group sessions.
Cognitive Behavioral Social Skills Training for Schizophrenia (CBSST). Eric Granholm, Ph.D. and his colleagues developed Cognitive Behavioral Social Skills Training (CBSST) to facilitate real-world functional improvement. CBSST combines cognitive behavioral therapy (CBT) and social skills training (SST) techniques, such as thought challenging, role-play practice of communication skills, and problem-solving training. It is a flexible, individually-tailored, manualized intervention that teaches cognitive and behavioral coping techniques, social functioning skills, problem-solving, and compensatory aids for neurocognitive impairments. CBSST targets the range of multidimensional deficits that can lead to functional disability in people with serious mental illness. CBSST is guided by a consumer treatment manual that describes the skills and includes at-home practice assignments.
Social Recovery Therapy (SRT). SRT is an individual psychosocial therapy that aims to improve social recovery by increasing the amount of time individuals spend in meaningful structured activities. SRT draws on Cognitive Behavioral Therapy (CBT); clinical resources, including outlines, guides, and video examples, can be found on the website above
Wellness Self-Management Recovery (WSM). WSM is an adaptation of the IMR model that assists individuals living with SMI manage their health. Topics include: Understanding what helps and what hinders recovery; Understanding how having goals helps recovery; Understanding how your cultural and family background affects decisions about mental health services; Practical facts about mental health symptoms, treatment, and causes; How social support and using community resources help recovery; How family and friends can support your work in WSM; Developing and using a relapse prevention plan; Knowing and using your strengths to support recovery; Finding and using coping strategies that work; Understanding the connection between physical and mental health).
Resources on Stigma Reduction
Stigma is a social process that involves labeling individuals and attaching negative stereotypes. This process can then result in discrimination toward people living with mental illness (e.g., at work, at school). More information on the process of stigma can be found in this short article (“Understanding the impact of stigma on people with mental illness”, Corrigan, 2002).
Organizations in the United States Dedicated to Stigma Reduction
There are many organizations in the US dedicated to stigma reduction, including but not limited to:
Internalized Stigma (also known as Self-Stigma)
Resources on the Recovery Model
Recovery is a process that occurs over time in a non-linear fashion. This is reflected in a definition developed by Substance Abuse Mental Health Services Administration (SAMHSA): Mental health recovery is a journey of healing and transformation for a person with a mental health disability to be able to live a meaningful life in communities of his or her choice while striving to achieve full human potential or “personhood.” Ten characteristics of recovery and recovery-oriented services were also identified by SAMHSA: 1. Self-direction, 2. Individualized and Person-Centered, 3. Empowerment, 4. Holistic, 5. Non-Linear, 6. Strengths-Based, 7. Peer Support, 8. Respect, 9. Responsibility, 10. Hope. The SAMHSA definition has become the standard for the field. It has been adopted by the Veterans Health Administration and several state mental health systems and will guide future SAMHSA funding programs. Others have made the distinction between recovery “from” an illness (i.e. disease is no longer present) to recovery “in” the illness, which emphasizes “learning how to live a safe, dignified, full, and self-determined life, at times in the face of the enduring symptoms of a serious mental illness” (Davidson et al., 2005, p. 324) and may be more relevant for many people for whom mental illness will be an ongoing condition. Recovery means learning to effectively manage symptoms and utilize wellness strategies in order to achieve the things that matter in life: love, work and community contribution. People in recovery often use mental health and peer support services continuously or intermittently to support recovery throughout the lifespan. For young adults experiencing a mental illness with psychosis, a recovery model is an essential component of mental health services.
Title: Substance Abuse and Mental Health Services Administration (SAMHSA) Recovery to Practice
Description: National website and materials on mental health recovery.
Title: SAMHSA’s National Consensus Statement on Mental Health Recovery
Description: “The consensus statement was developed through deliberations by over 110 expert panelists representing mental health consumers, families, providers, advocates, researchers, managed care organizations, state and local public officials and other.”
Title: Maryland Early Intervention Program – Online training in topics related to early psychosis treatment
Description: This website offers training videos on a range of topic related to working with young adults experiencing a mental illness with psychosis and their families including: Understanding the Experience of Psychosis Among Adolescents & Young Adults; The Family Experience of Mental Illness; First Episode Psychosis: Recognition, Assessment, and Treatment; Supported Employment & Education; Safety Planning for Professionals; Stigma in Young People with or at-Risk for Psychosis; An Introduction to Professional and Ethical Considerations in Early Psychosis; Using Motivational Interviewing Strategies with Young Adults with Early Psychosis; Assessing Risk for Psychosis; CBT Strategies for Those at-Risk for Psychosis. To access: (1) Click Sign Up! (2) Register for training program. (3) Then click Register for Maryland Early Intervention Program training; (4) Complete brief registration survey.
Title: OnTrackNY Voices of Recovery Videos
Description: This site provides videos featuring OnTrackNY participants, graduates, families, and team members.
Description: OnTrackUSA builds on our experience providing CSCs as part of the NIMH-funded RAISE Connection Program and its extension, OnTrackNY. OnTrackUSA helps to implement CSC teams that provide innovative, evidence-based, recovery-oriented treatment to young people who have recently begun experiencing psychotic symptoms. These teams help people achieve their goals for school, work and relationships. The site provides manuals and other web-based resources as well as consultation and training to programs and State agencies that would like to implement Coordinated Specialty Care teams (CSCs) for people with early psychosis.
Title: Common Ground, Dr. Pat Deegan
Description: Common Ground is a set of tools developed by Pat Deegan to support recovery and healing after a diagnosis of a mental illness.
Resources on Shared Decision Making (SDM)
Mental health clinicians and young adults may disagree regarding the goals of treatment and regarding specific treatment decisions. For example, mental health professionals are often more concerned with symptoms and illness management, while young adults are more concerned with practical matters like resuming employment and independent housing. Shared decision making (SDM) is an approach to setting goals and making treatment decisions that enables clinicians and young adults to clarify disagreements and to reach compromises. SDM relies on techniques such as decision aids, discussion of options, decisional balance exercises, comparing parallel ratings, and negotiating compromises. It aims to increase knowledge, to increase the young adult’s participation in and commitment to treatment, to enhance the professional’s understanding of the young adult’s values and preferences, and to strengthen the therapeutic alliance. SDM targets many factors associated with young adult satisfaction and identified barriers and facilitators of treatment utilization. SDM challenges traditional assumptions that the team member always knows what is best for an individual. Instead, SDM asserts that the best decisions about treatment are made when individuals collaborate with treatment team members. In the SDM process there are two experts in the room: the team member is an expert in the science and practice of medicine, and the young adult is an expert in what matters in his or her life. Numerous studies show that SDM improves the quality of decisions, young adults’ satisfaction, and the treatment alliance. In evidence-based practice in general medical care, SDM is associated with greater knowledge of health conditions and treatments, better treatment adherence and engagement, better health outcomes, and greater satisfaction with care. Studies using SDM approaches with individuals with schizophrenia suggest that participation in the decision-making process is feasible and that individuals can make rational, informed decisions regarding their treatment. Controlled trials of SDM in mental health settings, including studies of individuals with schizophrenia, show positive results (Kreyenbuhl, Nossel, & Dixon, 2009).
SDM provides a useful framework within which the preferences of young adults can be integrated with the recommendations of the mental health treatment team.
Title: The Lived Experience of Using Psychiatric Medication in the Recovery Process and a Shared Decision-Making Program to Support it.
Citation: Deegan, P.E. (2007). The lived experience of using psychiatric medication in the recovery process and a shared decision-making program to support it. Psychiatric Rehabilitation Journal, 31(1), 62-69.
Description: “This paper describes some of the challenges involved in making decisions about using psychiatric medications. It also details an innovative intervention to support shared decision making in psychiatry. The program includes a peer-run decision support center and a software program to support the activation of medical staff and clients in shared decision making.”
Title: Shared Decision Making and Medication Management in the Recovery Process
Citation: Deegan, P.E., & Drake, R.E. (2006). Shared decision making and medication management in the recovery process. Psychiatric Services, 57, 1636-1639.
Description: “The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment's advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder.”
Title: Dartmouth-Hitchcock Center for Shared Decision Making
Description: The Center for Shared Decision Making opened in 1999 as the first center in the U.S. dedicated to encouraging doctors and patients to make decisions together. Our services for patients being seen at Dartmouth-Hitchcock include provision of patient decision aids, decision support counseling, and facilitation of advance care planning discussions. Our Patient Support Corps volunteers help patients think about and organize their questions and concerns in preparation for an appointment and for patients being seen in Lebanon are also available to attend appointments to take notes and audio record to assist with retention of information.
Title: SAMHSA-HRSA Center for Integrated Health Solutions Share Decision Making Webpage
Description: This website provides resources for learning and using shared decision making in practice.
Title: Agency for Healthcare Research and Quality – SHARE Approach to Shared Decision Making
Description: AHRQ’s SHARE Approach is a five-step process for shared decisionmaking that includes exploring and comparing the benefits, harms, and risks of each option through meaningful dialogue about what matters most to the patient.
Supported Employment and Education Resources
Supported employment and education is an essential component of comprehensive early psychosis services. Because young people often initially want to focus on getting back to school and/or getting a job, supported employment and education are often the hook that pulls many young people into mental health services. The Individual Placement and Support (IPS) model is the most comprehensively researched approach and is currently widely viewed as offering the most effective evidence-based approach (Drake, Bond, & Becker, 2012). Growing evidence indicates that IPS may be also be the best method for assisting young people who have experienced a first episode of psychosis (FEP) with obtaining employment. Adapting IPS to young adults with FEP has involved including supported education as a focus in recognition that going to school is a common goal for this age group. The Substance Abuse and Mental Health Services Administration (SAMHSA) has recognized Supported Education as a “Promising Practice” which provides services that assist young people to gain access to and to be able to complete educational programs of their choice. It can help to ensure that developmental steps can be mastered by young people so that they can go forward to develop and qualify for meaningful careers. The IPS supported employment model focuses on rapid access to support for job search and retention of competitive employment. Employment specialists focus heavily on employer relationships and employment-related activities. Within an early psychosis setting, supported employment specialists have to be able to work with young people who often have no work history and who often are as focused on educational progression as on work. Young people may also be ambivalent or lack confidence in their ability to work, and the supported employment specialist may play the role of introducing them to the workforce for the first time. Further consultation is available through the Maryland EIP from Kim Reeder, M.Ed., MA, CRC, CHES, Consultant and Trainer, Maryland Early Intervention Program (email@example.com).
Resources for Supported Employment
Title: Locating Evidence-Based Practice (EBP) Supported Employment programs in Maryland that use the IPS model
Description: There are numerous Evidence-Based Practice (EBP) Supported Employment programs in Maryland that use the IPS model. The best way to determine what programs are available in your area is to contact your county’s Core Services Agency. The Core Service Agency staff collaborate with other human service agencies to promote comprehensive services for individuals with mental illness and substance use disorders who have multiple needs and includes supported employment services.
Title: Supported Employment Evidence-Based Practice (EBP) Toolkit
Description: This kit provides practice principles for supported employment, an approach to vocational rehabilitation for people living with serious mental illness. The kit promotes the belief that everyone living with serious mental illness is capable of working competitively in the community.
Title: The Employment Resource Book
Description: This resource book is designed for young people who have had mental health problems and are now considering finding a job, have already decided to find a job, or already have a job in the general workforce. Finding a part-time or full-time job in the general workforce—a job not set aside for people with disabilities—is known as competitive employment. This resource book is designed to help young people think about working and provide guidance before, during and/or after a competitive employment job search.
Title: Maryland Division of Rehabilitation Services (DORS)
Description: DORS helps people with physical, emotional, intellectual, developmental, sensory and learning disabilities go to work and keep their jobs by providing services such as career assessment and counseling, assistive technology, job training, higher education, and job placement. DORS will assign a counselor who will talk with the individual about DORS services and find out if they are eligible for these services. By age 14 DORS can help prepare students for future employment or training through activities such as job exploration and internship participation. During their last two years of high school, DORS can work with students on developing an employment goal and planning for the services that you will need to be successfully employed. Students in a special education program (e.g., have an I.E.P.), receive accommodations in school (e.g., have a 504 Plan) or have a significant health condition, may qualify or be eligible for certain DORS services.
Title: Transition Age Youth (TAY) Programs in Maryland
Description: There are several Transition Age Youth (TAY) Programs in Maryland that provide coordinated, high-fidelity evidence-based and empirically-supported services and supports that are youth-driven, developmentally-sensitive, and culturally and linguistically competent to TAY with a SMHC. Employment Specialists provide individualized placement and support services which are integrated and coordinated with mental health treatment providers, which are designed to assist youth and young adults with a to attain, maintain, and advance within competitive, community-integrated employment positions that pay at least minimum wage, are permanent, and are not set aside or reserved for individuals with disabilities. Supported Education (SEd) Transition Facilitators provide support to assist youth and young adults with SMHC in exploring career relevant education options, applying for admission and financial aid, advocating for accommodations, learning study skills, and staying on track for program or degree completion. Again, the best way to determine what programs are available in your area is to contact your county’s Core Services Agency.
Title: OnTrackNY IPS Supported Education and Supported Employment
Description: The OnTrackNY manual for supported education and employment is informed by the evidence-based practice, Individual Placement and Support (IPS) that was developed by the Dartmouth Psychiatric research Center. It has two parts. The first part consists of available resources for traditional IPS including the core IPS manual (Swanson, S.J, Becker, D.R., Drake, R.E., & Merrens, M.R. Supported Employment: A Practical Guide for Practitioners and Supervisors. Lebanon, NH: Dartmouth Psychiatric Research Center, 2008) and a volume that provides a focused discussion of supervision (Swanson, S.J. & Becker, D.R. Supported employment: applying the individual placement and support (IPS) model to help clients compete in the workforce. Minnesota: Hazelden, 2011.) The second part consists of this addendum to the core IPS manual.
Title: NAVIGATE: Supported Employment and Education Manual
Description: NAVIGATE is a comprehensive intervention program for people who have experienced a first episode of psychosis. Treatment is provided by a team of mental health professionals who focus on helping people work toward personal goals and recovery. More broadly, the NAVIGATE program helps consumers navigate the road to recovery from an episode of psychosis, including supporting efforts to function well at home, on the job, at school, and in the social world. The NAVIGATE program includes four different treatments, each of which has a manual: NAVIGATE Psychopharmacological Treatment Manual, Supported Employment and Education, Individual Resiliency Training (IRT), and Family Education. There is also a Team Members' Guide that describes the overall NAVIGATE structure and how team members work together, and a manual for the Director of the NAVIGATE team. This manual describes the NAVIGATE Supported Employment and Education and how to implement it.
Title: Helping Individuals Consider Employment: Tips for Mental Health Practitioners
Description: This is a worksheet designed to help mental health professionals engage in discussions with young clients about employment.
Resources for Supported Education (High School)
The Individuals with Disabilities Education Act of 2004 (IDEA) requires that an Individual Education Program (IEP) be developed for eligible students with disabilities so that they are provided a free and appropriate public education. A written plan must be designed to focus on improving the academic and functional achievements of student with disabilities to facilitate movement from school to postsecondary activities and prepare them for further education, employment, and/or independent living. It specifies how education, related services, and supports will be delivered to a student with disabilities. To the maximum extent appropriate, students with disabilities are to be educated in the Least Restrictive Environment with students who are non-disabled. The IEP is based upon a student’s ability to participate and progress in the general education curriculum, with appropriate adaptations to meet the unique needs of that student. The student’s ability to participate in general education classes and nonacademic and extracurricular activities is one of the most important matters to be discussed by the IEP team. The goal is to provide an appropriate education in the least restrictive environment in which the student’s needs can be met. Students with mental health needs who do not qualify for IEP may be eligible for services under Section 504 of the Rehabilitation Act of 1974, a federal civil rights law that prohibits discrimination against public school students with disabilities. Under the 504 Plan the school can make special accommodations for the student that remove barriers to learning, such as test taking adjustments, home instruction, and note taking assistance.
Supports for high school students may include: developing relationships with high school IEP case managers, guidance counselors, transition coordinators, social workers, and teachers; helping students, families, and school personnel understand how the onset of psychosis affects education; assisting students and their families with navigating high school IEPs and 504 Plans and meetings; advocating on behalf of students and families to school personnel to ensure that their rights and needs are being honored, and that they obtain needed reasonable accommodations and other needed resources; serving as a liaison between the student’s treatment team and school personnel; tracking students’ progress with school personnel to identify and minimize academic problems as early as possible; providing skills training and strategies regarding building good study skills, managing a course load, completing assignments on time, and taking tests; devising a system to track dates for tests and assignments; adding due dates and test dates to calendar, as well as, times to study or prepare projects/write papers; provide support and planning for difficult social situations at school; assisting those who have dropped out of high school and do not wish to return with finding and enrolling in a General Educational Development (GED) program; assisting with locating trade or apprenticeship schools and programs; and facilitating family meetings to discuss progress in school and family supports.
Title: Supported Education for Persons Experiencing a First Episode of Psychosis
Description: This issue brief describes supported education and how its services are organized. Topics addressed include the role of the treatment team, engaging young adults, and professional development for supported employment and education specialists.
Title: Understanding the Evaluation, Eligibility, and Individualized Education Program Process in Maryland
Description: This guide to understanding the evaluation, eligibility, and IEP processes in Maryland has been developed by the Maryland State Department of Education (MSDE) to help you better understand your child’s rights, your rights and responsibilities, and the school’s responsibilities to meet the special needs of your child. This guide includes a description of the Child Find, evaluation, eligibility determination, and Individualized Education Program (IEP) processes.
Title: 10 Tips: How to Use IDEA 2004 to Improve Your Child's Special Education
Description: This webpage provides information on ways to ensure that the needs of children with disabilities are met, while also improving educational outcomes and results.
Title: Special Education Rights: A Handbook for Maryland Families and Professionals
Description: This handbook is intended to provide parents, guardians and caregivers of school-age children with basic information regarding the special education process so they can advocate effectively for their children.
Title: Navigating the Transition Years: A Publication of the Maryland Coalition of Families for Children’s Mental Health
Description: This handbook brings together information and tools to navigate the transition process from youth to adulthood for children with emotional disabilities. The handbook is written for families, but the intent is that with this information, families can support their youth in self-advocacy
Title: What is a 504 Plan and How Can it Help my Teen?
Description: This tip sheet offers information on 504 plans.
Resources for Supported Education (College)
Providing supports to a student prior to starting a higher educational program may include identifying application requirements, resolving school debts, scheduling, preparing for, and taking admissions tests, assessing costs & eligibility for financial aid, loans, grants & scholarships, obtaining transcripts, completing essays, requesting & getting letters of recommendation, submitting applications and advocating for admission, enrolling, picking courses, and getting oriented, and linking to office of disability support services and other needed supports and resources. Supports after starting a higher educational program may include resolving transportation issues, accompanying to school or finding a classroom, buying books and other school supplies, planning ahead, teaching time management skills, minimizing academic problems, seeking social supports, offering strategies for coping with or reducing stress or anxiety at school and outside, and accessing tutoring centers, mentors and study groups.
Supports for the first week of classes may include: checking in with students after their first day of classes, and asking questions such as, Did you get to each class on time? How did it feel to be in class? Do you have any concerns?; helping students obtain planners or with setting up calendars on their phones, tablets, or laptops, and adding dates from course syllabuses including test dates and due dates for projects, while adding times to study and work on projects, and including student’s work schedule and regular appointments; and reviewing the planner together occasionally to prevent her from falling behind in class. Ongoing supports may include: meeting with students on a regular basis between classes at the college center or at their home to discuss how they are doing with schoolwork and social situations, etc., (especially with those starting their first semester); reviewing study plans and determining whether any adjustments are needed; asking about test results and grades on papers; reminding of dates for tests, and assignments; renewing financial aid applications; and assisting with registering with the office for students with disabilities, if accommodations are needed.
Title: Making My Way through College: A Guide for Students with Disabilities
Description: This primary focus of this guide is to help students with disabilities navigate the college experience.
Title: Getting Accommodations at College: Tools for School
Description: This tip sheet summarizes what extra supports and services colleges must provide to help students with mental health concerns succeed.
Title: Back to School: Toolkits to Support the Full Inclusion of Students with Early Psychosis in Higher Education: Student & Family Version
Description: This guide covers advance planning and communication, establishing relationships with campus staff, supporting your own well-being, campus self-advocacy, navigating disclosure, and campus stigma. There is also an orientation for families on topics related to supporting students with early psychosis in institutions of higher education.
Coming to terms with a mental illness is one of the most challenging endeavors a family can face. For many, mental illness strikes just when a young adult is gaining confidence in who they will become, how they will fit into their family and society, and fulfilling their own life dreams. When a young person experiences a mental illness with psychosis, the entire family is impacted. Parents wonder if their hopes and dreams for their child will be harmed, friendships change, and families can become more socially isolated by the stigma and shame that comes along with the diagnosis. Family members can experience a range of emotions. Some may experience denial, hoping that with more testing another explanation will be found. Others may experience sadness and fear at what the future holds. Having known no one who has been in a similar situation, many family members feel lonely and isolated and may not even have the words to explain what is happening to others who may under other circumstances provide support and encouragement. Some will express confusion and have little understanding of what is going on or what is best for their child. All of these are understandable reactions. It is normal to be angry, have feelings of guilt, and feel grief around having to figure out how to move past this new challenge that is now in front of you. Everyone goes through these stages at their own pace. If you are in one place today, you may be in another place tomorrow. Such changes are normal and will decrease over time. Things are not hopeless. There are many reasons to be optimistic about your loved one’s chances to recover, learn strategies that he/she can use to manage his/her feelings and symptoms, and pursue his/her career, social, and relationship goals. There are treatments that works so that young adults can lead fulfilling lives. It is especially important to get the correct diagnosis and treatment early. The sooner a diagnosis is made, and treatment is begun the more positive the outcome will be for the individual. In addition, building a network of natural supports is critical.
There are many ways that family members can help a person in recovery from psychosis. Family members and friends can:
Title: National Alliance on Mental Illness (NAMI)
Description: NAMI provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives. They offer information and guidance that can help family members of loved ones with mental illness, including young adults experiencing early psychosis.
Title: Substance Abuse Mental Health Services Administration (SAMHSA)
Description: SAMHSA offers resources for families and family-run organizations supporting behavioral health recovery and resilience for children, youth, and adults.
Title: National Institute of Mental Health (NIMH)
Description: This website provides printable materials such as factsheets, brochures, and a glossary. You’ll also find online and telephone assistance, informative videos, and more.
Title: Maryland Coalition of Families (MCF)
Description: MCF works in all counties in Maryland to help families access needed supports and services for their families and empower family members to advocate for improving services in all systems of care for children, youth, adults and families.
Title: The First Episode of Psychosis: A Guide for Patients and their Families
Citation: Compton, M.T., & Broussard, B. (2009). The First Episode of Psychosis: A Guide for Patients and their Families. NY: Oxford University Press.
Description: This book covers different mental health conditions, clarifies symptoms, discusses early warning signs, and includes treatment information for patients and families.
Title: Coping with Schizophrenia: A Guide for Families
Citation: Mueser, K.T., & Gingerich, S. (1994). Coping with Schizophrenia: A Guide for Families. NY: New Harbinger Publishers.
Description: This book includes problem-solving strategies (e.g., preventing relapses, regulating medications, finding community resources, responding to crises, and improving quality of life).
Title: The Complete Family Guide to Schizophrenia: Helping our Loved One Get the Most Out of Life
Citation: Mueser, K.T., & Gingerich, S. (2006). The Complete Family Guide to Schizophrenia: Helping our Loved One Get the Most Out of Life. NY: Guildford Press.
Description: This book explains schizophrenia and effective treatments, and then provides practical suggestions for managing symptoms. There are special sections on issues related to parents, children, siblings, and partners.
Title: Engaging with Schools to Support Your Child with Psychosis
Description: This tip sheet provides information on how to coordinate with schools when their child is experiencing psychosis. Information is provided related to disclosing a diagnosis, reducing bullying, setting goals, engaging support and accommodations, and preparing for school support team meetings.
Title: Schizophrenia and Related Disorders Alliance of America (SARDAA)
Description: SARDAA “promotes improvement in lives affected by schizophrenia-related brain illnesses (mental illnesses involving psychosis). SARDAA promotes hope and recovery through support programs, education, collaboration, and advocacy.” Of note, SARDAA offers a family and friends support group (call-in), in addition to other resources.
Resources for Clinicians who are Working with Families
Family Psychoeducation is an evidence-based practice that combines education about mental illness with training in problem solving, communication skills, coping skills and developing social supports. The goals are to enable families to communicate and problem solve more effectively as a means to reduce relationship stress and support recovery. Further consultation is available through the Maryland EIP from Bette Stewart, Consultant/Trainer, Department of Psychiatry, University of Maryland School of Medicine (firstname.lastname@example.org).
Description: This toolkit offers evidence-based practices to help public officials develop family psychoeducation mental health programs. The programs create a partnership between consumers, families, practitioners, and supporters. The kit includes a brochure (English, Spanish), nine booklets, a PowerPoint presentation, and a introductory video.
Title: Family Psychoeducation Workbook
Description: This workbook is for mental health practitioners and case managers learning and applying this approach to treatment and recovery and for clinical supervisors and mental health program leaders as a reference for program development and ongoing administration.
Title: Training in Family Psychoeducation at the PIER Institute
Description: The PIER Institute providers training in evidence-based practices including Family Psychoeducation.
Title: OnTrackNY Family Treatment and Resources Manual
Description: This manual outlines the OnTrackNY model for working with families and offers practical activities and interventions for young people and their families.
Title: I am not sick, I don’t need help!: How to help someone with mental illness accept treatment.
Description: This book provides information to families on how to help a family member who may deny their illness/symptoms. The book has information on family communication, community services, and research on anosognosia.
Resources for Youth
The Teen Brain: 7 Things to Know "This fact sheet outlines how a teenager’s brain grows, matures, and adapts to the world. It also presents information on the teen brain’s resiliency, vulnerability to stress and mental health problems, and sleep patterns in teens."
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.
Resources for Linking Young Adults and Families with Community and Peer-Led Organizations
An important goal is for young adults and their families to develop natural supports within the community. There are three general sets of community resources that will be needed for many young adults: (1) Mental health or clinical services not provided by the clinician or the clinic in which she/he is working, such as cognitive behavioral treatment for depression, anxiety disorders, or PTSD; inpatient substance abuse treatment, dialectical behavior therapy; (2) non-psychiatric medical services such as primary care services, lab services, other medical care, substance use detoxification; (3) peer or community support resources such as NAMI, AA/NA, Double Trouble, Depression and Bipolar Support Alliance. The clinician can actively assist the young adult in exploring and trying out such programs and activities. The exact nature of this assistance will differ for individual young adults – some will require only a referral while others will ask for more help in contacting a resource or want the team member to accompany him/her to the first or first several appointments/meetings.
Title: Family Peer Support Programs and Youth Groups - Maryland Coalition of Families
Description: MCF has a statewide staff of approximately 35 Family Peer Support Specialists and Substance Use Family Peer Support Specialists, all of whom have personal experience caring for a child with a behavioral health disorder. They provide information and referral, services navigation, and one-to-one family peer support and advocacy. Many MCF staff offer parent/caregiver support groups. Our staff usually work with caregivers whose children are under the age of 18 (with the exception of our substance use staff, who work with many families of young adults). MCF has two young adult groups, but both are advocacy groups, not support groups.
Title: On Our Own of Maryland, Inc.
Description: On Our Own is a non-profit organization that provides a wide array of self-help and advocacy programs and support groups across the state for people with mental illnesses.
Title: On Our Own of Maryland’s Transitional Age Youth Outreach Project
Description: The Transitional Age Youth (TAY) Outreach Project empowers young adults ages 18–29 with mental health and substance use struggles to share their experiences and speak out about the kinds of help and services they’d like to see within the behavioral health system where they receive care. This project hopes to foster an understanding that the life experiences of young adults are full of unique insights, and that they are able to reach out and touch the lives of other young adults through peer support, and as advocates for a behavioral health system which adequately addresses their needs and honors their voices.
Title: Strategic Sharing Youth Advocacy Guide: National Federation of Families for Children’s Mental Health
Description: This workbook is for individuals who have experienced traumatic life experiences and are interested in sharing their stories in an effort to promote change. Training in Strategic Sharing is an important part of advocacy – we encourage anyone who has experienced traumatic life events and wishes to share those experiences in an effort to promote positive changes for yourself and/or others, to do so with the help of this guide.
Title: Youth Leadership Toolkit: National Resource Center for Youth Development
Description: NRCYD’s philosophy is that youth engagement is a powerful way for organizations to include the young people they serve, in moving their work forward to better serve youth. The Youth Leadership Toolkits provides the fundamentals of meaningful youth engagement strategies.
Title: Schizophrenia and Related Disorders Alliance of America (SARDAA)
Description: SARDAA “promotes improvement in lives affected by schizophrenia-related brain illnesses (mental illnesses involving psychosis). SARDAA promotes hope and recovery through support programs, education, collaboration, and advocacy.” Of note, SARDAA offers a peer support group that clients/consumers can call into, in addition to other resources.
Resources to Educate School Personnel about Psychosis
Title: What Every Teacher and School Professional Needs to Know about Psychosis and Young People
Description: This booklet is designed to introduce school professionals to the core competencies of detection, referral, and support of students experiencing the early signs of psychosis. It aims to assist school professionals in: Recognizing the early symptoms of psychosis, understanding the causes of psychosis, utilizing a Learning Support Toolkit of easy-to-use student support strategies, and facilitating referrals to mental health resources
Title: Supporting Students Experiencing Early Psychosis in Middle School and High School
Description: This booklet is a guidance document for what school personnel can do if they suspect psychosis. Information is provided on how to identify warning signs, connect to evidence-based treatment, and best support students and their families. To this end, the booklet highlights the importance of school-based modifications and accommodations if needed, safety concerns, and how to reduce stigma in schools.
School Staff Can Aid Treatment of Psychotic Children
Mental Health in Schools: A Role for School Resource Officers
UThink Resources for Schools (3 MB PDF)
Psychosis Screening Tools for Use in Schools
Overview of Screening Tools (book chapter)
Kline, E., Denenny, D., Reeves, G., & Schiffman, J. (2014). Early identification of psychosis in schools. In Handbook of School Mental Health (pp. 323-338). Springer, Boston, MA.
Overview of Screening Tools (journal article)
Meyer, M. S., Rosenthal, A., Bolden, K. A., Loewy, R. L., Savill, M., Shim, R., ... & Niendam, T. A. (2019). Psychosis screening in schools: Considerations and implementation strategies. Early Intervention in Psychiatry. Advance online publication.
Prime Screen, Revised (Prime)
Millman, Z.B., Rakhshan, P.J., DeVylder, J.E., Edmondson Smith, M., Phalen, P.L., Woods, S.W.,…& Schiffman, J. (2019) Evidence for differential predictive performance of the prime screen between black and white help-seeking adolescents. Psychiatric Services, 70, 907-914.
Prodromal Questionnaire – Brief (PQ-B)
Loewy, R. L., Pearson, R., Vinogradov, S., Bearden, C. E., & Cannon, T. D. (2011). Psychosis risk screening with the Prodromal Questionnaire—brief version (PQ-B). Schizophrenia Research, 129, 42-46.
Behavior Assessment for Children (BASC)
Thompson, E., Kline, E., Reeves, G., Pitts, S. C., Bussell, K., & Schiffman, J. (2014). Using parent and youth reports from the Behavior Assessment System for Children, to identify individuals at clinical high-risk for psychosis. Schizophrenia research, 154, 107-112.
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.
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American Psychiatric Association's Healthy Minds Blog
EASA and FEMHC Program Directory of Early Psychosis Intervention Programs (2016)
Maryland Coalition of Families
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)
Visit the official Maryland EIP Facebook page and "Like" so you can stay informed about EIP
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
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
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
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 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 Crisis Team/Hotline: (410) 931-2214
National Council on Alcoholism and Drug Dependence, Inc.
National Institute on Drug Abuse (NIDA)
Substance Abuse and Mental Health Services Administration (SAMHSA)
EPOCH Counseling Center (Baltimore County) and Resources
Harbel Prevention and Recovery (Baltimore City)
Mountain Manor Treatment Center (Locations throughout Maryland)
The Recovery Village (Upper Marlboro) and Resources for Friends and Family
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)
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.)