First Episode Psychosis (FEP)
Psychosis is characterized as a disruption of thoughts and perceptions which impact the ability to distinguish between what is real and not real. Psychosis impacts approximately 100,000 youth and young adults each year. It is estimated that 3 in 100 individuals experience psychosis in their lifetime. Many individuals may have only one experience of psychosis while others may have ongoing symptoms.
First episode psychosis (FEP) is the first time an individual experiences psychotic symptoms or a psychotic episode. This may include hallucinations (seeing, hearing, smelling, tasting, feeling things that are not real), delusions (false beliefs), difficulty thinking (difficulty concentrating, thoughts that are not connected, racing thoughts, etc.), change in emotional state (strong emotions, inappropriate emotions to situation, or no emotions), and change in behavior.
The causes of psychosis are complex and could result from a number of different factors. For some, psychosis may result from substance use or a wide variety of medical illnesses (e.g., dementia, epilepsy) and specific interventions for these illnesses can resolve the psychosis. However, when psychosis occurs in the period of emerging adulthood (ages 16-35), it can mark the beginning of a chronic mental illness, like schizophrenia, bipolar disorder or depression. Early intervention with evidence-based treatment can help individuals recover during a vulnerable developmental phase of their lives. Some may have only one experience of psychosis, others may fully recover after quitting substances (e.g., cannabis, amphetamines) while others will need ongoing monitoring and care.
Someone who experiences their first psychotic episode may be quite frightened. He or she may not understand what is happening to them and may be afraid to tell others. However, there is help and recovery is possible. Research indicates that early intervention leads to better overall outcomes, and there are now evidence-based treatment models that can help those who are diagnosed with chronic schizophrenia spectrum disorders.
The Department of Mental Health and Addiction Services provides funding to two leading FEP treatment programs: the Program for Specialized Treatment Early in Psychosis (STEP) at Connecticut Mental Health Center and the Young Adult Services POTENTIAL Track at the Institute of Living.
Specialized Treatment Early in Psychosis (STEP) Program, Yale University Department of Psychiatry and the CT Department of Mental Health and Addiction Services
The Specialized Treatment Early in Psychosis (STEP) Program is a collaborative program between the Connecticut Department of Mental Health and Addiction Service and Yale University Department of Psychiatry. The program has been recognized as model for Coordinated Specialty Care by the National Institute of Mental Health. The STEP Program operates out of the Connecticut Mental Health Center in New Haven, Connecticut. STEP serves individuals who have experienced the onset of psychosis in the prior 3 years and reside within a 10-town catchment surrounding New Haven (including East Haven, West Haven, North Haven, Bethany, Orange, Woodbridge, Milford, Branford and Milford). The multidisciplinary team implements a comprehensive care pathway that includes early detection, structured and longitudinal assessment, coordinated specialty care (CSC) and transition to usual community-based care.
STEP works with individuals and their families to develop and implement a personalized recovery plan. Clinical care within the CSC model includes: medication and physical health management, individual and group therapy, Family Support and Education, Coordination with natural community supports, and Supported Education and Employment. For more information, please refer to the STEP website at www.medicine.yale.edu/psychiatry/step
The Young Adult Services POTENTIAL Track at the Institute of Living
The Young Adult Services POTENTIAL Track at the Institute of Living (IOL) is part of an umbrella of services through IOL’s Young Adult Services Program. The POTENTIAL Track is a specialty service for young people between the ages of 18-26 who are experiencing first episode psychosis. It is an intensive, outpatient program offered three days per week. Individuals may be experiencing symptoms that are new to them or symptoms that may not have been treated in the recent past. A multidisciplinary team provides support and education to both the young person and their family. Treatment includes individual, group, and family therapy as well as medication management to help the young person get back into their life and achieve personal goals while managing their experiences. The Institute of Living also provides services and activities which focus on expanding opportunities towards social connection.
For more information, please refer to the Young Adult Services POTENTIAL Track website at https://instituteofliving.org/programs-services/young-adult-services/programs/potential-track
STEP 169 is a collaboration between the Department of Mental Health and Addiction Services, Department of Children and Families and the Yale University Department of Psychiatry. The purpose of the program is to bring specialized treatment to individuals across Connecticut who are experiencing first episode psychosis. More information regarding the program will be forthcoming.
Other available resources:
For more information, please contact Lisa Zurolo at Lisa.Zurolo@ct.gov or 860-418-6679.