Getting help: For young people with psychosis, early intervention is crucial
Andrew Echeguren, 26, had his first psychotic episode when he was 15. He was working as an assistant coach at a summer soccer camp for kids when the lyrics coming out of his iPod suddenly morphed into racist and homophobic slurs, telling him to harm others - and himself.
Echeguren fled the soccer camp and ran home, terrified the police were on his heels.
He tried to explain to his mom what was happening, but the words wouldn’t come out right. His parents rushed him to a children’s crisis center, where an ambulance arrived and transported him to the adolescent psychiatric facility at St. Mary’s Medical Center in San Francisco.
“I thought it was a joke,” Echeguren said. “I didn’t think it was really happening because I didn’t know what was real or not.”
Echeguren received antipsychotic medication, was put in a quiet room and looked after by attentive caregivers who helped stabilize him.
Many young people don’t get the care they need so rapidly after a psychotic episode, if at all. As a result, they can become chronically disabled, and some end up homeless, incarcerated or addicted to drugs.
“Early intervention preserves the most important pieces of a young person’s life - relationships with family and friends, success at work or school,” said Tara Niendam, executive director of Early Psychosis Programs at the University of California-Davis.
Research corroborates Niendam’s view. Some states have created early intervention programs and have expanded existing ones.
Nationally, the median time between the first symptoms of psychosis and the start of treatment is nearly a year and half, according to a study by the National Institute of Mental Health. That is six times longer than the World Health Organization’s recommendation of three months or less.
Psychosis refers to a group of mental disorders, such as schizophrenia, that cause people to lose contact with reality. The average life span of people with major mental illnesses is up to 32 years less than for the general population, largely because they are at greater risk for multiple chronic diseases.
“These people don’t live beyond their late 50s,” said Insel, a former director of the National Institute of Mental Health. “It’s not a pretty picture. It’s a sad statement of where we are in the way we treat this illness.”
Mental health experts say the most effective early psychosis treatment is something known as coordinated specialty care, which incorporates medication and psychotherapy with case management, support groups for the patients’ families and assistance securing employment or education.