Oregon organization helps young people recover from psychosis

Editor’s note: This story discusses psychosis and mental health. If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by calling or texting “988” or chatting online at http://988lifeline.org/.

When Mindy Gale’s child reached middle school, she noticed a shift in their behavior. 

The Multnomah County mom noticed her child was experiencing mood swings and depression, and they withdrew from theater and singing — hobbies they had previously loved. At one point, her child started having paranoid hallucinations, including one in which they described feeling moths underneath their skin trying to escape. 

It became clear that her child was experiencing psychosis, a broad term used to describe symptoms that can include hallucinations, delusions and difficulty distinguishing what is real and what’s not. 

“It’s just really hard to describe how isolating and scary and full of grief that experience was to watch the child that you’ve cared for and loved and brought up essentially disappear and be replaced with someone very different,” she said. “It’s very confusing and scary.”

At the time, it felt like she had lost her child, she said. With help from experts, Gale said she’s come to terms that she had to align to a different path than she expected. 

Gale found help for her child through the Early Assessment Support Alliance, which its users and staff call EASA, pronounced “ee-suh.” 

Mental health advocates created the organization in 2001 to provide services to diagnose and treat the early symptoms of psychosis. The Oregon Legislature officially provided funding for the program in 2008. Since then, it’s grown to offer programs serving every county in the state.

Oregon program focused on early psychosis intervention

The Early Assessment Support Alliance has served roughly 6,500 Oregonians since the Legislature funded it, and it treats about 700 people at any given point, according to Megan Sage, the organization’s director. 

EASA is designed to intervene with psychosis early. Studies show that earlier treatment is associated with a better response to treatment and a greater likelihood of a good recovery.  

An estimated 15 to 100 people out of every 100,000 develop psychosis each year, according to the National Institute of Mental Health. It often begins in the late teens to mid-20s, though people can experience a psychotic episode at a younger or older age.

The programs are available regardless of a person’s ability to pay, insurance status or immigration status so long as they meet eligibility criteria. Eligible people are between age 12 and 30 and either at risk for developing psychosis or experienced their first episode of psychosis within the past 12 months. 

The program provides individualized treatment that can include medication, counseling, family support, substance use treatment, occupational therapy and access to peer support groups. Services generally last two years. 

Many people graduate from the programs with a plan in place for medical management without needing a lot of support, Sage said. Others develop schizophrenia-spectrum disorder and may require more long-term support and medication management. 

“We really try to communicate the hope that recovery is not only possible; it’s probable and it’s highly likely,” Sage said. 

Some people may experience a relapse of symptoms after graduating from the program, Sage said, but the organization helps individuals develop a plan for what to do if that happens.

Approximately 60% of clients upon graduation do not receive disability benefits, Sage said. 

“Sometimes disability is a path for folks, and there’s nothing wrong with that, but we always try to instill the message that there’s lots of possibilities for people,” she said. “Just because you experience psychosis doesn’t mean you can’t do so many things and live a full life.”

For Gale, that possibility once felt difficult to imagine. It’s been nearly eight years since her child graduated from EASA services. Now, her child lives independently in an apartment and has a support team in place to help manage their needs.

“EASA really felt like a lifeline to our family in one of the darkest, hardest times we’ve ever navigated,” Gale said.