Is it real or not real? Do I have psychosis?

Transcription

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2 Is it real or not real? Do I have psychosis? Understanding Psychosis Getting Screened Getting Help

3 Understanding Psychosis Rachel Loewy, Ph.D University of California, San Francisco

4 What is Psychosis?

5 Psychotic symptoms Hallucinations, delusions Positive Symptoms Social withdrawal, decreased motivation Negative Symptoms Disorganized behavior, communication changes Disorganized Symptoms Attention, verbal memory, executive function Cognitive Symptoms Changes in ability to manage school or work Changes in Functioning

6 What is Early Psychosis?

7 Progression of Early Psychosis 1-3 yrs 3-5 yrs Childhood Adolescence Adulthood No Symptoms Non-specific symptoms noticed by person Sub-psychotic symptoms Psychotic affects functioning level symptoms Treatment success

8 Perceptual Abnormalities

9 Fusar-Poli, et al. (2012), Arch Gen Psychiatry, 69 (3):

10 Detection Self-Report Screening with the Prodromal Questionnaire

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12 Prodromal Questionnaire Self-report screening 4 versions Specialty clinic referrals Undergraduates Catchment areas Web-based screening

13 Prodromal Questionnaire 4 Major Scales (92 Items, True/False) Positive, Negative, Disorganized and General Items based on SIPS, SPQ and additional items. Sample items: Sometimes I think that people can read my mind. I tend to avoid social activities with other people. UCLA UHR clinic (N= 113) 90% sensitivity, 49% specificity, 78% PPV, 69% NPV PQ positive symptoms >8 Loewy, et al (2005), Schizophrenia Research, 79(1):117-25

14 PQ - Brief Version (PQ-B) 21 positive symptoms with highest SIPS agreement Not endorsed at high rates by undergraduates Distress/impairment Loewy, et al (2007), Schizophrenia Research, 93(1-3):144-51

15 Other studies 3533 young adults seeking outpatient mental health services; 420 interviewed 87% accuracy 12% psychosis, 35% high-risk (3x CHR referral rate) 12 month transition rate: 23% screen vs 8% referral Ising, et al (2012), Schizophrenia Bulletin, 38(6): Rietdijk, et al (2012), Acta Psychiatr Scand, 126(1):21-30 suomi Finnish nederlands Dutch italiano Italian 한국어 KOREAN PORTUGUÊS PORTUGUESE

16 Getting Online Screening Theresa Nguyen, LCSW Mental Health America

17 MHAScreening.org July 2015 Oct 2016 Psychosis Screen (PQ-B) 49,685 Screens

18 What we re looking for Familiar things seem strange, confusing, threatening, or unreal. Hearing sounds or voices that others don t. Visual distortions: trails, ghosts shadows or wavy lines Feeling disconnected, out of control, that things aren t real or quite right, or that things are happening to your thoughts. Extreme fear for no apparent reason.

19 Other Changes Difficulty speaking or understanding what others are saying Strange ideas that aren t normal to those around you Anxious and depressed mood - isolation Change in sleep, appetite or hygiene Withdrawal from friends and family Dramatic decrease in ability at school or work: Reading, Speaking, Coordination (sports), Attendance or Grades

20 What s going On? More people over time are coming to take the Psychosis Screen 2 % - before May % - May to July % - Aug to Today 79 % score At Risk

21 Answers Worry at times that something might be wrong with my mind Feel like others are watching me Feel mistrustful or suspicious of others Difficulty getting my point across go off track when I talk Hear unusual sounds Confused if things are real or imaginary

22 What People Want Information about mental health Use at home - worksheets or coping skills to Online or mobile program that can help you track or manage your symptoms Referrals to those that can help Phone number for immediate support % % % % % Screening to Supports User Driven and Customizable Information and Education Referral to Care and Services DIY: Selfhelp Tools Engagement with People Like Me (Peers)

23 What people want

24 Digital Pathways to Care For Young People Facing Psychosis Chantel Garrett, P4SM Founding Director Carlos Larrauri, P4SM Youth Leader

25 Connecting to Care & Resources partners4strongminds.org strongmindsproject.org Treatment Tracker Education Center Learn track For youth, by youth Know Your Mind Get Strong Stories of Strength

26 At our Fingertips 3.5 BILLION Google searches per day. 1 in 20 relate to health.

27 Carlos Story Board of Directors for NAMI- Miami Dade County Family Nurse Practitioner student at the University of Miami Struggling Musician

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29 Keyword Testing 2,000 keywords linked to >200 Ads 980 keywords (88 ads) generated clicks to landing pages

30 Sample Ads Theme Description Call to action

31 Messaging Most effective ad themes: Bipolar Disorder Signs & Symptoms (74% of clicks!) Mental illness / Psychosis Test (10%) Delusions / Suspicion (5%) Heavy search volume + relatively less expensive than other top terms.

32 Messaging Most effective description lines: You're Not Alone. We Can Help (93% of clicks) Hard To Tell What s Real? (3%) Most effective call to action: Take An Online Quiz & Find Support (55% of clicks) Learn The Signs & Find Support (38%)

33 Demograhics Age Age distribution was fairly evenly split across four age groups: 18-24, 25-35, 35-44, with a slight spike in the range. Gender

34 Website Stats

35 Help Seeking Actions

36 Why early intervention is important Improved brain functioning Better & faster recovery Decreases need for more intensive treatment Improved coping skills Improved self advocacy Avoid self medication through drugs Higher success in school & work Improved relationships with family & friends Reduces suicide risk!

37 Get Connected MHAscreening.org strongmindsproject.org partners4strongminds.org SAMHSA.gov SAMHSA treatment locator ( SAMHSA s National Helpline HELP (4357); (TDD) National Suicide Prevention Lifeline

38 3 8 This webinar was developed [in part] under contract number HHSS I/HHS T from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.

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