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Early Psychosis and the Delaware CORE Program

Written on: September 15th, 2017 in Health and WellnessMental IllnessTreatment

What is Psychosis?

Psychosis is an illness affecting the structures and chemicals of the brain that enable us to experience emotions, make judgments, and perceive the world around us. The three most common problems associated with this illness are hallucinations (seeing or hearing things that are not there), delusions (beliefs that are odd or untrue), and disorganization (becoming confused and fragmented when attempting to think or speak). Other symptoms include fearfulness, difficulty making decisions, strong sensitivity to light and noise, problems paying attention, and emotional distress.

Psychotic experiences are actually fairly common. About 10-25% of youth and young adults report having at least one such experience in their lifetime, but in most cases these are mild and do not last very long. For 1 out of 50 youth, these experiences become sufficiently intense, frequent or long-lasting and interfere with daily routines and well-being.

Problematic psychosis tends to appear between the ages of 12 to 25. These are the ages when youth grow from being dependent on adults to assuming responsibility for making life decisions, taking care of one’s self and, eventually, taking care of others. Supporting a young person with psychosis is particularly challenging because the illness sometimes requires that he or she be heavily dependent on family and friends. Meanwhile, the people providing the support have to balance that individual’s need for support with his and her developmental need for independence. Sometimes it can be hard to know what to do.

What is Delaware CORE?

One aspect of treatment for psychosis that is reliably linked to better outcomes is the period of time that symptoms are left untreated, or as it is commonly referred to: “the duration of untreated psychosis” or just DUP. Researchers have long agreed that the more one waits to get treatment the greater the potential for harm. People who engage early on improve their chances for avoiding (or mitigating) episodes and maintaining a more meaningful quality of life.

Over the past two years, a program entitled Community Outreach and Early Intervention (CORE) has been working in Delaware for the purpose of shortening DUP by engaging young people (ages 12-25) who are experiencing their very first signs or symptoms of psychosis. With start-up funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), Delaware CORE has been implementing a program that was developed by the Maine Medical Center nearly a decade ago.

That parent program, called the Portland Identification and Early Referral (or PIER) program, has been effectively improving the quality of life for youth or young adults with early psychosis for nearly a decade. The program’s developers attribute program success to the combined insight of a diverse professional team (e.g., prescribers, occupational therapist, educational specialist, social workers) and careful tracking of an individualized treatment plan for each enrollee. PIER philosophically rejects medicine as a stand-alone intervention and promotes stress reduction and practical problem solving as essential parts of the recovery process. Team members also maintain an aggressive outreach program to help raise public awareness and reduce stigma.

Does Delaware CORE work?

Back in July of 2015, Delaware CORE convened its first two teams (i.e., eight clinicians). Those teams now serve the entire state. The program offers a broad array of services including psychiatric consultation, occupational evaluation and therapy, supportive services for school or work, and inter-family group meetings to promote networking and support. Over sixty individuals and their families have enrolled.

Preliminary outcomes – based on the first 46 enrollees in CORE – are promising.

How can I learn more?

To learn more about Delaware CORE or arrange to have a team member come speak to you or your organization, call (888) 284-6030 or go to



Neonatal Abstinence Syndrome

Written on: September 7th, 2017 in FamilyPreventionSubstance Abuse/Addiction

Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article summaries a New England Journal of Medicine review of current literature on neonatal abstinence syndrome, including clinical characteristics, prevention, identification, and treatment. Epidemiology The incidence of the neonatal abstinence syndrome has increased substantially in […]

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Addicting Effects of Prescription Medications

Written on: August 7th, 2017 in PsychiatryResearchSubstance Abuse/Addiction

Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This blog post is a follow up to last week’s post on the Surgeon General’s Report on Alcohol, Drugs, and Health. This article includes information from reports by the Washington Post-Kaiser Family Foundation, the Center for Disease […]

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Facing Addiction in America, the Surgeon General’s Report on Alcohol, Drugs, and Health

Written on: August 1st, 2017 in FamilyHealth and WellnessSubstance Abuse/Addiction

Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article summarizes the Facing Addiction in America, a report on alcohol, drugs, and health issued by the Surgeon General.   Facing Addiction in America, the Surgeon General’s Report on Alcohol, Drugs, and Health was published […]

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Family Partners Empowers Families

Written on: July 28th, 2017 in FamilyMental IllnessPeer Support

Raising children is a major, and often challenging, responsibility for every parent and guardian. When childhood mental illness is added to the mix, it can become even more demanding. It is important for every Delaware parent and guardian, regardless of their circumstance, to know that help is available. One evening every month families gather in […]

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August Events for Delaware Youth

Written on: July 26th, 2017 in CommunityPrevention

The Delaware Department of Services for Children, Youth, and their Families (DSCYF), is sponsoring several events the first week in August. These events are sure to fill August with fun and excitement for Delaware’s young people. The Delaware Independent Living Program invites current and former foster youth aged 14 years and older to attend the 15th Annual Youth Advisory […]

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Defining Behavioral Health Terms: Evidence-Based Practice

Written on: July 17th, 2017 in Early InterventionPreventionResearchTreatment

You may hear the term Evidence-Based Practice, or EBP, to describe a skills-development or treatment program and wonder what that really means. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines Evidence-Based Practice as a practice that based on rigorous research that has demonstrated effectiveness in achieving the outcomes it is designed to achieve. […]

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Alcohol Facts and Statistics

Written on: July 12th, 2017 in Health and WellnessPreventionSubstance Abuse/Addiction

Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article provides Alcohol Facts and Statistics across a range of areas that impact functioning and mortality. Alcohol Facts and Statistics According to the National Institute of Health’s National Institute on Alcohol Abuse and Alcoholism an […]

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Children’s Psychiatric Services Needed

Written on: July 10th, 2017 in Mental IllnessPsychiatryTreatment

Request for Proposals to Provide Children’s Psychiatric Services Issued The State of Delaware’s Department of Services for Children, Youth and their Families (DSCYF) issued a Request for Proposals (RFP) for licensed medical practitioners to provide psychiatric services to children served in the following settings: • two residential mental health treatment centers (RTCs), which also provide outpatient day treatment, • staff-secure […]

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Mobile Response and Stabilization Services Now Available!

Written on: July 1st, 2017 in Health and WellnessMental IllnessSubstance Abuse/AddictionSuicide and Prevention

When a family is in the midst of an emotionally charged situation involving a child who is struggling emotionally or behaviorally, it can be hard to decide what to do and how to calm things down. Our Mobile Response and Stabilization Services (MRSS) are here to help. MRSS is available to address the needs of […]

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