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Rutgers opens clinic to address psychosis in young adults

Psychotic illness affects approximately 100,000 young people nationwide, according to the National Institute of Mental Health. But until recently, New Jersey had no clinics to help teens or young adults within their first two years of exhibiting symptoms when intervention is likely to be most effective.

Rutgers University Behavioral Health Care (UBHC) recently opened a first-episode psychosis outpatient clinic in its Edison Metroplex location to serve 15-to-35-year-old residents of Middlesex, Monmouth and Mercer counties, funded by a grant from the New Jersey Division of Mental Health and Addiction Services, according to information provided by Rutgers University. Two other grant-funded clinics – in Paramus, managed by Care Plus, and in Cherry Hill, managed by Oaks Integrated – also recently began serving young adult patients in those regions.

Psychosis – characterized by an impaired sense of reality – typically occurs between the ages of 18 and 28. First-episode symptoms appear gradually, often pushing people into state of denial: They know something is amiss but assume it is temporary, according to Steven Silverstein, Rutgers’ clinic director.

Troublesome signs include seeing or hearing things that no one else does, withdrawing from family and friends, having difficulty concentrating and experiencing a decline in self-care.

“They may not admit they have a diagnosis of a psychotic disorder, but they will admit that they are having experiences – like lack of concentration, poor grades or hearing voices – that are interfering with meeting their life goals,” Silverstein said.

New Jersey is among a growing group of states addressing care for young adults who have experienced early psychosis, following a 2016 Congressional mandate requiring that states set aside 10 percent of their mental health block grant for use in treating first-episode psychosis.

Focusing on how recent changes are interfering with life goals, rather than on whether the person does or does not have a disorder such as schizophrenia, is an important part of motiving a young person to enter treatment, according to the statement. A clinic dedicated to young adults and staffed by professionals with specialized knowledge in treating this population, such as UBHC’s, is key to long-term success.

“There are big changes that happen in the brain from about two years before the onset of psychotic symptoms to three years after,” Silverstein said. “This is why early identification of people in need of treatment, and provision of treatment as early as possible, are critical. Unfortunately, the average person with a first episode of psychosis currently can go 15 months or longer with symptoms before treatment is provided, leading to greater challenges in helping a person recover.”

UBHC’s program, which can treat up to 50 people at a time, accepts patients who are within two years of the onset of psychotic symptoms, such as auditory hallucinations, severe paranoia or delusional ideas. Prior hospitalization is not required to qualify for treatment.

The clinic plans to treat patients for about a year before transitioning them to a traditional outpatient program. While under the clinic’s care, people in treatment meet weekly, or as needed depending on treatment goals, with different members of the treatment team, including a therapist, psychiatrist, family therapist, peer support and wellness specialist and a substance abuse counselor, according to the statement.

Patients also can use the services of an employment and education specialist, who can provide them with support as they transition back into a job or to school.

The clinic also educates families on how to work with the treatment team and support their loved ones.

“The goal is to reduce a person’s symptoms so they can return to their lives, needing less treatment,” Silverstein said. “Ideally, after an initial period of more frequent assistance, they can scale back to coming to this clinic or another program once a week or less.”

For more information, call the clinic at 732-235-2868.

 

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