UC Irvine researchers have launched a new countywide system of care designed to identify and support youth and young adults experiencing early warning signs of psychosis. The initiative, beginning this month, is backed by a $2.6 million grant from the Substance Abuse and Mental Health Services Administration and will run for four years.
The program focuses on individuals aged 15 to 25 and seeks to connect them with support services before a first episode of psychosis fully emerges. Jason Schiffman, a UCI professor of psychology and associate dean for research and faculty welfare for the School of Social Ecology, co-leads the effort with Dr. Cameron S. Carter, UCI Distinguished Professor and chair of psychiatry and human behavior. Schiffman noted that research suggests 2 to 4 percent of young people meet criteria for clinical high risk for psychosis, indicating thousands in a county the size of Orange County could benefit from specialized assessment and support.
Over the four-year grant period, the program intends to provide treatment and coordinated care to more than 150 young people. An estimated 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 include experiences such as hallucinations, delusions, and disorganized thinking, frequently appear first during adolescence and early adulthood. Researchers have recognized a critical period before a full episode, during which symptoms are developing but have not yet crossed a clinical threshold. Reaching young people during this window has historically presented challenges. Schiffman explained that early signs can be subtle and might overlap with concerns such as anxiety, depression, trauma, or sleep problems. He added that young people may recognize something feels different but struggle to explain it or worry about others' reactions, and even when concerns are recognized, stigma persists, and available services have often been fragmented.
Addressing these early signs is seen as crucial for more than just symptom management. Adolescence is a period for forming friendships, pursuing education, and beginning careers, and the risk of psychosis can affect these milestones long before a formal episode. The program aims to address distress, support families, and assist young people in maintaining engagement in their lives in ways consistent with their values and passions. If psychosis does develop, the goal is for specialized treatment to begin promptly.
This initiative represents a collaboration between experts in psychological assessment and management of at-risk youth and psychiatrists and psychologists skilled in treating more intense symptoms, including the full onset of serious mental illness. It seeks to ensure that youth identified in the community can be linked to appropriate levels of care.
The program is designed to integrate with the existing support networks for young people. For example, a school counselor observing a student becoming withdrawn or a pediatrician noting an inexplicable 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 from this screening leads to a structured clinical interview with a trained UCI clinician.
From that point, the young person is matched with care, which may include cognitive behavioral therapy for many, psychiatric consultation for those with more severe symptoms, and supported education and employment programs for individuals seeking that level of assistance. The initiative draws on three complementary partners: UCI Psychiatry’s iEDAPT early psychosis clinic, UCI Psychology’s Together Clinic, which is directed by Naomi Tabak, Ph.D., who also oversees 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 may notice subtle changes, such as a teenager becoming inexplicably withdrawn or describing experiences that seem unusual, Schiffman advises seeking help before certainty of what is happening. He states that a diagnosis is not required to seek an assessment and that waiting for a crisis is unnecessary. He emphasized that being at elevated risk does not mean psychosis is inevitable, and most young people identified as clinically high risk do not develop a disorder related to psychosis. However, many are experiencing distress and deserve support, and the program is available to help. For those who do go on to experience psychosis, the connection to specialty care is already established, ensuring a team is available to coordinate the transition and connect families with others undergoing similar experiences.
Schiffman, who co-founded Thrive Together OC in 2021 and has trained over 1,000 Orange County providers, views the grant as a formalization of years of groundwork. He noted that UCI’s research has already influenced national guidelines for early psychosis intervention, impacting programs beyond Orange County. The challenge, he said, has not been a shortage of resources, as communities typically have schools, primary care providers, therapists, and community organizations. Rather, the missing element has been the connective tissue: clear referral pathways, shared training, and the coordination needed to transform a loose network of services into a functional system. The program's goal is to support everyone in living a life of their own choosing.
