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noise rustling in the background rather than the classic haunting voices. Other signs may include changes in behavior— tendency to isolate from others and a drop in performance at school or work—and changes in thoughts or perceptions— marked suspicion of others and having unusual beliefs.
“It’s all about the brain,” Hanna-Ronald says. “Just like any other organ in the body, there can be illness.”
Several decades ago, European re- searchers discovered that addressing early psychosis by teaching patients cop- ing skills and problem solving can help to delay, reduce symptom intensity or even completely prevent full psychosis, Webb says.
DPBHS worked with Dr. William Mc- Farlane, who developed the revolutionary Portland Identification and Early Referral Program in Maine, and in October 2014, received a five-year, $5 million grant from the U.S. Substance Abuse and Mental Health Administration to found Delaware CORE, one of the growing number of pro-
grams that exist in the country to address early psychosis.
CALL TO MIND
The program began operating in ear- nest in 2015 and has served approximately 55 patients to date, with many of the refer- rals coming from middle and high schools. Each person begins the intake process with a prescreen interview over the phone, where one of Delaware CORE’s clinicians will ask general questions about the onset of early psychosis symptoms, medications and any history of hospitalizations.
If that patient shows signs of the condition, the program will set up an in-person session based on the more definitive Structured Interview for Psychosis-Risk Syndrome co-authored by Dr. Barbara Walsh of Yale School of Medicine. Webb calls this step a crucial part of the intervention process. When this assessment comes back positive, it suggests a person has a one in three chance of developing full psychosis.
Delaware CORE’s staff explains the
findings with the patient and his or her family, engaging them in a series of joining sessions to see if they want to participate in the voluntary program.
“We perform extensive psycho-educa- tion about what’s going on with their loved one,” Hanna-Ronald says. “It helps to de- mystify everything, builds a rapport and removes blame.”
Delaware CORE tailors its services to meet the specific needs of each person, but main program facets include clinical sup- port, psychiatric support if medication is needed, and educational, vocational and occupational consultation.
“They may be struggling in school or at work because the symptoms interfere with how they process information or stay on task if they’re disrupted by sensory ex- periences,” Hanna-Ronald says.
In another important part, several fam- ilies in the program come together for biweekly group sessions to help problem solve their issues and receive continued education from Delaware CORE facilita- tors, Webb says.
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10 302Health issue 2.2017-18