Early intervention can alter lives of young adults

Early intervention can alter lives of young adults

8/4/2017 12:00:00 AM

Team members are excited about the great outcomes among their consumers, ages 15-25: employment, avoidance of hospitalization (12 in a recent quarter), return to school, improved social skills and reintegration with their families. Most importantly, these young adults are learning that the symptoms of mental illness don’t need to define their lives or pre-determine their futures.

“The early intervention model we are using is showing results of interrupting schizophrenia and the lifelong challenges these young adults could face,” says Tonya Mangold, service coordinator, Wyandot Center Young Adult Team.  

The EIT is a joint effort of Wyandot Center and PACES and a subset of the Young Adult Team. Jennifer Krehbiel is the EIT leader/therapist. Wyandot Center and PACES were the only agencies awarded grant funds by the state of Kansas to start this program.

Nadine Cumberbatch-Payne, PACES service coordinator and liaison with the EIT, describes the program as directed toward “changing the story of what mental illness looks like for these young adults. ‘Living with mental illness’ is much different language and more empowering than ‘having a mental illness,’” she says. “This approach is also changing my perspectives as a clinician.”

Early recognition of symptoms 
Typically, symptoms of schizophrenia develop when a person is in his/her late teens or early 20s. This is a unique time in a person’s life as the individual emerges into adulthood, wants to connect with peers and may not understand emerging symptoms.

Symptoms of psychosis/schizophrenia include hearing voices or seeing things other people don’t; isolation; a shift in performance at school; involvement with law enforcement – all factors that are out of character for young adults. “When a parent notices change in the young adult and says, ‘I don’t know where my child went,’” says Dennis Moyers, recovery coach, “this is a warning sign.”

“We’re up against the delusions and the psychosis itself,” says Tonya. “The young adult is in transition, learning to define him/herself and figure out the world. If there’s nothing done to intervene or challenge the delusions, it’s difficult to find hope.”

The key is connecting young adults with interventions early in the evolution of their psychoses. “If we can identify the symptoms early,” Jennifer says, “we can help keep these young individuals on the path toward productive lives. We’re paying a lot more attention to early symptoms.”

The model adopted 
Our EIT adopted the RA1SE model for early intervention. RA1SE stands for Recovery After First Schizophrenia Episode. Core components of this emerging best practice include:
• A low-dose anti-psychotic regimen based on the “start low, go slow” philosophy.
• Cognitive behavioral therapy for schizophrenia.
• Education and family support.

Former practice for treating psychosis at onset may have included rushing the brain with a higher dose of an anti-psychotic medication intended to disrupt symptoms. The meds often impaired the brain to the extent that therapy wasn’t effective, and consumers frequently dropped out of treatment due to feeling overmedicated and less able to function or engage in the life they once knew. RA1SE’s “start low, go slow” approach allows for an effective combination of meds, therapy, family education and support.

Another distinction with RA1SE is that the normal route for determination of severe and persistent mental illness (SPMI) does not apply to this program. “We take young adults (most of whom are 18 or 19) regardless of their payer sources and without diagnoses,” Tonya says. “What we’re looking for are emerging symptoms of psychosis.”

Services available 
There are multiple entry points that bring consumers to the attention of the Early Intervention Team;  among them, outpatient services, RSI, law enforcement and our housing resource center. Jennifer, a licensed professional counselor, does the initial assessment and rules out medical symptoms and substance abuse. If psychosis appears to be the challenge, she connects consumers with the treatment team. Symptoms may be difficult to identify and pin down initially. But the team can accept consumers for the program based on possible or emerging symptoms.

Team members provide community outreach to family members to determine their level of involvement and openness to family support. “We’re finding that interactions with the early intervention process can also be life-changing for the family,” says Edie Harrison, family support and education intern for EIT. 

Consumers in the EIT program receive customized and individualized services. Alexandra Dwight is a vocational consultant who connects with young adults in this program. As a recovery coach, Dennis facilitates individual resiliency training, outreach and a weekly educational group. Edie meets with families to provide support and education in the program. Kate Mettman, APRN psychiatric mental health nurse practitioner, is the provider who works with the young adults. EIT also engages participants in ArtMakers’ Place, social interaction groups and advocacy efforts.

“Instead of allowing the symptoms to disrupt their lives, we are working as a team to engage these young adults in their lives,” Tonya concludes.

Call 913-328-4600 or email mangold_t@wmhci.org for more information