UC Irvine researchers are launching a countywide system of care this month designed to identify early warning signs of psychosis in young people. The four-year initiative, supported by a $2.6 million grant from the Substance Abuse and Mental Health Services Administration, seeks to engage and partner with youth aged 15 to 25 before a full episode of psychosis takes hold.
The effort brings together UCI faculty, clinicians, students, researchers, and community partners. Jason Schiffman, UCI professor of psychology and associate dean for research and faculty welfare for the School of Social Ecology, co-leads the program with Dr. Cameron S. Carter, UCI Distinguished Professor and chair of psychiatry and human behavior. According to Schiffman, research indicates that approximately 2-4% of young people meet criteria for clinical high risk for psychosis. Applied to a county the size of Orange County, this suggests thousands of young people could benefit from specialized assessment and support.
Over the grant's four-year period, the program aims to provide treatment and coordinated care to more than 150 young people. An additional 500 to 600 brief screenings are anticipated each year, with outreach efforts extending to families, schools, healthcare providers, and community organizations. Disorders involving psychosis, which can manifest as hallucinations, delusions, and disorganized thinking, frequently emerge during adolescence and young adulthood. Researchers have identified a critical period before a first full episode, when symptoms are developing but have not yet crossed a clinical threshold.
Historically, reaching young people during this window has presented challenges. Schiffman noted that "early signs can be subtle" and can overlap with other concerns such as anxiety, depression, trauma, or sleep problems. A young person might recognize that something feels different but struggle to explain it or worry about others' reactions. Even when concerns are recognized, stigma remains a significant barrier, and available services have often been fragmented.
The stakes extend beyond symptom management. Adolescence is a crucial period for forming friendships, pursuing education, and starting careers, and psychosis risk can quietly undermine these milestones long before a formal episode occurs. Schiffman highlighted the opportunity to address distress, support families, and help young people remain engaged in their lives in ways that align with their own values and passions. If psychosis does develop, the goal is for specialized treatment to begin promptly.
This initiative represents a collaboration between experts in the psychological assessment and management of youth at risk and psychiatrists and psychologists specializing in treating more intense symptoms, including the full onset of serious mental illness. It is designed to ensure that youth identified in the community can be linked to the appropriate level and intensity of care.
The program is structured to meet young people where they are, beginning with the adults already in their lives. A school counselor noticing a student becoming withdrawn, or a pediatrician observing an unexplained decline in a patient's grades, can now initiate a referral into a clear, connected system. Following a referral, a brief screening questionnaire is administered. A positive result leads to a structured clinical interview conducted by a trained UCI clinician. From there, the young person is matched to appropriate care, which may include cognitive behavioral therapy, psychiatric consultation for those with more severe symptoms, and supported education and employment programs.
The initiative draws on three complementary partners: UCI Psychiatry’s iEDAPT early psychosis clinic, UCI Psychology’s Together Clinic, led by Naomi Tabak, Ph.D., who directs the Psychological Services Center within the Department of Psychology, and Thrive Together OC, a county-supported nonprofit co-founded by Schiffman. Together, these entities form a continuum from community identification through treatment and ongoing support.
For parents who have observed concerning changes, such as a teenager becoming inexplicably withdrawn or describing experiences that seem unusual, Schiffman advises, "You can ask for help before you’re certain of what’s happening." He emphasizes that parents do not need to diagnose their child or wait for a crisis to seek an assessment. Being at elevated risk does not mean psychosis is inevitable; most young people identified as being at clinical high risk do not develop a disorder related to psychosis. However, many are experiencing real distress and require support, which the program aims to provide.
For those who do go on to experience psychosis, the connection to specialty care is already integrated into the program, as Schiffman and Carter noted. If a first episode occurs, the team is available to help coordinate that transition and connect families with others undergoing similar experiences, fostering a sense of community and support. Schiffman, who co-founded Thrive Together OC in 2021 and has personally trained over 1,000 Orange County providers, views the grant as a formalization of years of preparatory work. He stated that the funding strengthens the ability to offer clear, helpful next steps for families and to build services intended to last beyond the grant period.
UCI’s own research has already influenced national guidelines for early psychosis intervention. The challenge, Schiffman explained, is not a shortage of resources, as most communities already possess schools, primary care providers, therapists, and community organizations that can contribute. Instead, what has been missing is the connective tissue: clear referral pathways, shared training, and the coordination necessary to transform a loose network of services into a functional system. The program's aim is to support everyone in living a life of their own choosing.
