UC Irvine researchers are establishing a new countywide system designed to identify and support teenagers and young adults exhibiting early warning signs of psychosis. This initiative, launched this month, seeks to connect individuals aged 15 to 25 with support and intervention before a full psychotic episode develops.
The effort is backed by a $2.6 million grant from the Substance Abuse and Mental Health Services Administration and will operate over four years. It unites UCI faculty, clinicians, students, researchers, and community partners to address a critical, often missed window in young people's lives. Jason Schiffman, a 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.
Schiffman noted that research indicates approximately 2-4% of young people meet criteria for "clinical high risk for psychosis." Applied to Orange County’s population, this suggests thousands of young individuals could benefit from specialized assessment and support. The program aims to provide treatment and coordinated care to more than 150 young people over the grant period. An additional 500 to 600 brief screenings are anticipated annually, with outreach efforts extending to families, schools, health care providers, and various community organizations.
Disorders involving psychosis, which can manifest as hallucinations, delusions, and disorganized thinking, frequently emerge during adolescence and young adulthood. Researchers have recently identified a crucial period before a first full episode, during which symptoms develop but have not yet crossed a clinical threshold. Reaching young people during this window has historically presented significant challenges.
Schiffman explained that early signs can be subtle and may overlap with other concerns such as anxiety, depression, trauma, or sleep problems. A young person might recognize that something feels different but struggle to articulate it or worry about others' reactions. Even when a concern is recognized, deep-seated stigma and fragmented services have often impeded access to help.
The stakes extend beyond mere symptom management. Adolescence is a period when crucial life milestones occur, including forming friendships, pursuing education, and beginning careers. The risk of psychosis can quietly undermine these developments long before a formal episode is diagnosed. Schiffman emphasized that this initiative offers an opportunity to address distress, support families, and assist young people in remaining engaged in their lives in ways consistent with their personal values and passions. If psychosis does develop, the program aims to ensure specialized treatment begins promptly.
The program is structured to connect with young people through the adults already present in their lives. For example, a school counselor observing a student becoming withdrawn, or a pediatrician noting 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.
Based on this assessment, the young person is matched to appropriate care. This may include cognitive behavioral therapy, psychiatric consultation for those with more severe symptoms, and supported education and employment programs for individuals seeking that level of assistance. The initiative leverages three key partners to form a continuum of care, from community identification through treatment and ongoing support: UCI Psychiatry’s iEDAPT early psychosis clinic, UCI Psychology’s Together Clinic, directed by Dr. Naomi Tabak, and Thrive Together OC, a county-supported nonprofit co-founded by Schiffman.
For parents who observe changes in their teenager, such as inexplicable withdrawal or descriptions of experiences that do not quite make sense, Schiffman advises seeking help before being certain of a diagnosis. He stated that it is not necessary to diagnose a child or wait for a crisis to seek an assessment. Being at an elevated risk does not guarantee psychosis will develop; most young people identified as being at clinical high risk do not go on to develop a psychosis-related disorder. However, many are experiencing real distress and require immediate support, and the program is available to assist.
Schiffman and Carter highlight that for those who do experience psychosis, the connection to specialty care is already integrated into the program. If a first episode of psychosis occurs, the team is prepared to coordinate that transition. The program also intends to connect families with others undergoing similar experiences, fostering a sense of community and reminding them they are not alone.
For Schiffman, who co-founded Thrive Together OC in 2021 and has trained over 1,000 Orange County providers, this grant formalizes years of foundational work. He noted that UCI’s research has already influenced national guidelines for early psychosis intervention, impacting programs beyond Orange County. Schiffman believes the primary challenge is not a lack of resources, as most communities already possess schools, primary care providers, therapists, and community organizations that can contribute. Instead, the missing element has been the "connective tissue": clear referral pathways, shared training, and the coordination necessary to transform a loose network of services into a functional system. He added, "We believe in helping to support everyone to be able to live a life of their own choosing."
