The effects of psychosis can be devastating on both individuals and their families, especially for those aged 18 to 25, the period classified as emerging adulthood.
“Unfortunately, I’ve heard many stories through my work: People are doing well in school or recently started their careers, and they have an interruption that was caused by mental illness,” says Elizabeth Thomas, a research scientist in Temple University’s Collaborative on Community Inclusion. As these young adults experience symptoms like hallucinations or delusions, she said, “they start to withdraw socially...They often don’t know how to deal with that.”
Thanks to a new K08 award from the National Institute of Mental Health, Thomas is beginning a four-year project seeking to better engage emerging adults with early psychosis in evidence-based early intervention services known as coordinated specialty care (CSC). She’ll develop a peer-delivered decision support intervention for these young adults, as people with mental illness typically are more engaged when receiving support from others who have shared that experience.
Peers in the project will provide coaching to help young people make decisions about their care—peers offer a level of emotional connection that other care providers often cannot and have the ability to share firsthand knowledge of the experience.
For the first two years, Thomas and others on the project will interview young people already in a local program undergoing early psychosis interventions. Together with a mentorship committee composed of researchers and international experts on early intervention, they will try to answer questions that will guide the pilot program: What are their treatment decision-making needs? What have they experienced so far? What parts of their treatment experiences have been most difficult?
After this period of information gathering, they will begin two years of the pilot study with 20 early adults in interventions at Psychosis Education, Assessment, Care and Empowerment (PEACE) in Philadelphia, a CSC program that helps people manage the early stages of psychosis.
The peers will work with adults in the first six months of treatment, a critical time for young adults to seek support. But many choose not to do so, and between 20 and 40 percent of those who begin interventions end up disengaging from services early.
The effect is drastic: For those experiencing early signs of psychosis, early and consistent treatment can help emerging adults feel minimal long-term impact. That is, psychosis symptoms don’t have to prevent people from living fulfilling, functioning lives. The program, Thomas hopes, will keep emerging adults engaged during this critical period.
Housed in the College of Public Health, the Collaborative on Community Inclusion seeks to “target obstacles that prevent people with psychiatric disabilities from fully participating in their communities, develop the services and support consumers and communities need to promote full integration into all aspects of community life, and expand the range of opportunities for people who have psychiatric disabilities to participate in their communities as active, equal members.” In the Collaborative, researchers across public health disciplines partner with individuals who have lived experience with serious mental health issues, policymakers, and care providers.