Slides of Dr. Barbara Walsh presenting Mindmap information.

1. PSYCHOSIS: SYMPTOMS, WARNING SIGNS
AND STEPS TO EFFECTIVE TREATMENT

2. THE BASICS
Psychological and emotional difficulties are like other
medical problems; early signs and symptoms usually
occur before serious illnesses develop. As with other
medical illnesses, the sooner psychological problems are
identified and treated, the less likely they are to disrupt a
person’s ability to study, work, make friends and be with
others. Early identification and treatment can lead to a
better prognosis.

3. OUR MISSION:
To work with our community to transform
pathways to care for those who have recently
suffered the onset of a psychotic illness or are
showing the warning signs that they may be at
risk of developing a serious mental illness like
psychosis
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

4. The Genetics of Mental Disorders
 Psychotic disorders are complex and appear to
involve multiple susceptibility genes interacting
with multiple environmental factors throughout
the development of the person. The nature of
these interactions is very complex and poorly
understood at this time.
 In order to avoid the deterministic viewpoint of
mental illness, it is crucial to emphasize the
importance of the environment and lifestyle
choices and that there is hope for recovery.
 Taking illicit drugs is a preventable risk factor,
as is excess stress.

5. PSYCHOSIS IS MORE COMMON THAN
YOU THINK
• More common than Multiple Sclerosis and Muscular Dystrophy combined
• Psychosis effects about 3% of the world’s population
FOR EVERY ONE
PERSON AFFECTED
BY PSYCHOSIS,
THERE ARE 6 MORE
FAMILY AND FRIENDS
AFFECTED
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

6. IT’S A YOUNG PERSON’S DISEASE
• Most mental illnesses are chronic diseases of the young
• Symptoms commonly first appear in people age 12-25
35
85% OF PEOPLE
SUFFERING FROM
PSYCHOTIC
ILLNESSES
DEVELOPED THIS
BEFORE THEY
TURNED 35
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

7. SO WHAT IS PSYCHOSIS?
Psychosis is a mental health problem that causes people to
perceive or interpret things differently from those around them.
This might involve hallucinations or delusions. It is any severe
mental disorder in which contact with reality is lost or distorted.
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

8. Psychosis
Positive Symptoms Negative Symptoms
Hallucinations Lack of interest
Delusions Lack of motivation
Thought Disorder Lack of pleasure
Bizarre Behavior Social withdrawal
Blunted affect
Lethargy
Apathy

9. Phases of Psychosis
PREMORBID AT RISK ACTIVE
Functioning
Course of Illness
*First appropriate
treatment
Onset of illness
Duration of Untreated Psychosis
Decrease in functioning,
Beginning of mild but not
yet psychotic symptoms.

10. Summary of Relevant Research
1) Early Identification and early intervention
appear to lead to better prognosis.
Australian EPPIC Program
2) It is possible to reduce the
duration of untreated Psychosis.
Norwegian TIPS Project
3) It appears to help to identify people
“at risk” for serious mental illness.
British Early Intervention Study
4) It is possible to identify people in a
pre-psychotic state.
PACE, TOPS, and PRIME Data

11. TIPS LATE-BREAKING FINDINGS
Baseline ED vs UD Differences
- Less suicidality with ED
- Less involuntary hospitalization with ED
- Holds true even 10 years out

12. Case for Early Intervention
• At onset, already present are:
• Measurable cognitive impairment
• Measurable gray matter volume loss
• Damaging social development losses
• Diminished capacity to actively engage in treatment

13. SO WHAT ARE THE COMMON CAUSES
OF PSYCHOSIS?
• mental illnesses (e.g. schizophrenia)
• medical illnesses (e.g. epilepsy)
• substances: such as alcohol or drugs
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

14. JUST LIKE ANY OTHER MEDICAL
PROBLEM
• People suffering from psychosis did nothing to “cause”
their disease
• It requires treatment just like any other illness or injury
• The sooner someone gets treatment the more likely
they are to get better
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

15. THE KEY TO SEEKING HELP IS
UNDERSTANDING
SYMPTOMS AND SIGNS
• Hallucinations - seeing or hearing things that aren’t there
• Delusions - believing things that aren’t true, and are often impossible
• Thought Disorder - trouble putting thoughts in order or keeping track of usual tasks
• Lack of insight and self-awareness
The combination of hallucinations and
delusional thinking can often severely disrupt
perception, thinking, emotion and behavior.
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

16. SIGNS OF PSYCHOSIS
Watch for changes in behavior such as:
• withdrawing from usual activities with friends
• spacing out or falling behind in tasks
• social isolation
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

17. SIGNS IN SCHOOL
• Falling asleep in class
• Struggling with basic work
• Paying less attention to personal appearance and hygiene
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

18. Behaviors of Concern
 Withdrawal/Isolation
 Ongoing Social Difficulties
 Poor Hygiene
 Bizarre Behavior/Appearance
 Falling Asleep in Class
Repeatedly
 Sadness/Tearfulness
 Excessive Anxiety
 Absenteeism/Staying in Room
 Poor Concentration/ Spacing
Out
 Hypervigilance
 Decrease in Work
Performance/Activity Level
 Becoming Neglectful and
Unfeeling
 Emotional Outbursts/Emotional
Flatness

19. Behaviors of Concern
 Identify recent changes
 Identify more than one behavior of concern
 Identify distress level associated with behavior of
concern
 Identify interference with functioning associated with
behavior of concern

20. Early Warning Signs of
Psychosis:
Increased difficulty at school or work
Withdrawal from friends or family
Difficulty concentrating or thinking clearly
Suspiciousness or mistrust of others
Changes in the way things look or sound
Odd thinking or behavior
Emotional outbursts or lack of emotion
Poor personal hygiene
Is someone you know at risk?

21. Some Typical Queries and
Responses
 Have you felt that you are not in control of your
own ideas or thoughts?
 Do you ever feel that your mind is playing tricks on
you? Déjà vu, minding reading?
 Your ears? More sensitive to sounds? Ringing in
your ears? Name being called? Cell phone
ringing?
 Your eyes? More sensitive to light? Flashes,
flames, vague figures or shadows out of the corner
of your eyes?
 Do you seem to be having trouble getting your
point across? Following multi-step directions?

22. Changes in the Way Things Look
or Sound
• Wind rushing by ears
• Noisy pipes
• Hall to the Cafeteria

23. Odd Thinking
• School class watching him
• Traffic lights have meaning
• Friends might be only pretending
• Teachers might be against

24. “IT STARTED WITH MY
LOSS OF INTEREST IN
BASICALLY EVERYTHING”
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

25. WHAT TO DO IF YOU SEE THE SIGNS
If you believe you see the signs of psychotic disorder in
someone you know then they need your help.
IF YOUR FRIEND
WAS HURTING
YOU’D CALL
A DOCTOR
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

26. CALL FOR HELP
STEP CLINIC
203-589-0388
www.mindmapct.org
PRIME CLINIC
1-866-AT-PRIME OR 203-785-2100
http://primeclinic.yale.edu

27.  Treatment is effective. The sooner treatment is
started, the better the recovery.
MYTH:
TREATMENT DOESN’T WORK
#1
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

28.  Early treatment often happens in an office. The patient
comes in for treatment and then goes home again.
MYTH:
TREATMENT MEANS BEING
LOCKED IN A HOSPITAL
#2
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

29. OUR TREATMENT:
• a full assessment of your needs to navigate a
clear path to mental health
• rapid referral to appropriate service in local
community or engagement in STEP or PRIME
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

30. OUR TREATMENT:
• prescriptions for medications when required
• psychotherapy
• education and support for patients and
families
• support for employment and educational
goals
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

31. INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT
 High School
 College
Mental Health
Services
Public
Charity/Clergy
Primary Care
Hospital
Social
Services
Judicial
Police/Probation
Consumer/
Youth/Orgs.
Branches of
Government
PATHWAYS TO CARE: MINDMAP

32. STEP CLINIC
• PERSONS AGED 16 – 35 WITH PSYCHOSIS EARLY
IN THE COURSE OF TREATMENT
• DIAGNOSTIC CLARIFICATION EVALUATION
• MEDICATION MANAGEMENT, INDIVIDUAL, GROUP,
FAMILY THERAPY, & VOCATIONAL ENGAGEMENT
• FLEXIBLE, INDIVIDUALIZED, RECOVERY
ORIENTED TREATMENT WITH EMPHASIS ON
ENGAGEMENT

33.  Free
 Effective
 Local
HELP IS AVAILABLE
203 589 0388
www.mindmapct.org
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

34. PRIME CLINIC
203-785-2100
• PERSONS BETWEEN 12 - 35 YEARS OF AGE
• CAN RESIDE ANYWHERE AS LONG AS CAN COME INTO
THE CLINIC IN NEW HAVEN
• MUST HAVE MINIMUM IQ OF 70
• MUST HAVE NEVER MET CRITERIA FOR FULL BLOWN
PSYCHOSIS
• PROVIDES CLINICAL EVALUATION, DIAGNOSTIC
CLARIFICATION, COMMUNITY EDUCATION,
CONSULTATION WITH COMMUNITY PROVIDERS &
SCHOOL PERSONNEL, & TREATMENT STUDIES
* ALL SERVICES ARE FREE OF CHARGE

35. Dr. Barbara Walsh
203-974-7052
Call (TOLL FREE) 1-866-at PRIME
or 203-785-2100

36. OUR COMMUNITY
ONLINE:
OWNED MEDIA
EARNED MEDIA
PAID MEDIA
INTRO PREVALENCESYMPTOMSSIGNS MYTHS TREATMENT

37. 203 589 0388
www.mindmapc

39. WHAT CAN YOU DO?
SPREAD THE WORD