Early intervention for psychosis programs
Early intervention in psychosis is an approach to early symptoms of psychosis that is part of a broader prevention paradigm in mental health. Such programs reflect a hopeful prognosis and the expectation that recovery is possible. With an emphasis on community-based care, early detection, early psychosis treatment teams and phase-specific treatment, these programs aim to reduce the long-term impact of the condition.
Recovery After an Initial Schizophrenic Episode (RAISE) is a research project run by the National Institute of Mental Health. This project aims to fundamentally change the trajectory and prognosis of schizophrenia via aggressive treatment in the earliest stages of the illness. RAISE seeks to help people with schizophrenia lead productive and independent lives.
OnTrackNY is an evidence-based team approach to provide recovery-oriented treatment to youth who have started to experience psychotic symptoms more recently. This program is run through the New York State Office of Mental Health, in collaboration with many other organizations. OnTrackNY takes many notes from the successful RAISE initiatives in New York State.
Through public education and policy advocacy, the National Psychosis Prevention Council aims to raise awareness and funds to speed the expansion of prevention-oriented research and treatment. The Council’s goal is to accelerate transformation in the care model for psychosis in the U.S. towards prevention and recovery.
For the growing number of districts using restorative justice, the programs have helped strengthen campus communities, prevent bullying and reduce student conflicts. And the benefits are clear: Early adopting districts have seen drastic reductions in suspension and expulsion rates, and students say they are happier and feel safer.
This program for elementary students combines elements of two program models, PeaceMakers and the Good Behavior Game, to foster self-control and group regulation as well as a classroom environment conducive to learning. In the game, students to “flip on” their internal focus switch, required for any learning. It teaches students how to work toward valued goals, and teaches them how to cooperate with each other to reach those goals. Students learn cooperation and self-regulation during both learning and fun, lessons which are generalizable to many areas of school life.
Compared to control groups, students who participated in the program experienced:
- Reduced rates of conduct disorder five years after the program.
- Improved math and reading skills in 12th grade (up to 8 years after the program)
- Better chance of graduating from high school
- Reduced rates of initiating drug use by 8th grade
- Reduced rates of alcohol, drug and tobacco use by early adulthood
Says SAMHSA, "This elementary school (K-6) program is designed to promote positive youth development by creating a kind and supportive school environment to meet students' needs for emotional and physical safety, caring relationships, autonomy, and a sense of competence. The four components of the program are implemented over the course of the school year and include: (a) a forum for students and teachers to get to know one another and discuss issues that impact classroom climate; (b) the building of positive, cross-age relationships in the school; (c) activities to support communication at home and make connections between school learning and home experiences and perspectives; and (d) broad-based community-building activities to support positive connections between students, parents, teachers, and other school staff. Ideally, the program is implemented school-wide."
Compared to schools that did not implement the program, schools that did implement Caring School Community had outcomes including:
- Improved academic performance
- Reduced rates of alcohol and drug use
- Reduced number of disciplinary referrals
This program works with students who have experienced adversity such as family conflict or highly chaotic home life, and seeks to build resiliency. By providing kids with emotional and social support, the CBSG program teaches life skills to promote coping strategies; healthy choices; anger management; positive goal setting; and skills to resist peer pressure. It involves weekly group support sessions oriented on different topics, over the course of 10-12 weeks, and has been used in schools, shelters and community-based organizations.
Children who participated in CBSG experienced outcomes including:
- Improved coping skills
- Improved social skills
- Decrease in anti-social attitudes
- Increase in negative attitude toward substance use
- Decrease in inhalant use
The ALIVE program, first implemented in the public school system in New Haven, CT, is designed to support students who have experienced trauma and adversity by identifying and reducing sources of toxic stress in children's lives. According to SAMHSA, the program's focus areas include helping students develop coping skills, emotional literacy and empathetic skills; providing stress reduction sessions; professional development and support for teachers; using arts, drama, music and poetry to help students self-express and enhance self-worth; and accessible counselors for kids needing further behavioral, emotional or academic support.
The ALIVE initiatve was so successful that, in 2013, the Mayor of New Haven announced the expansion of the ALIVE program throughout the public school district in an effort to address widespread childhood adversity.