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.
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.
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 www.delawarecore.com