UC Irvine researchers have launched a new countywide system of care designed to identify and support young people showing early signs of psychosis. The four-year initiative, backed by a $2.6 million grant from the Substance Abuse and Mental Health Services Administration, commenced this month at UCI. Its goal is to intervene before a first episode of psychosis fully takes hold in individuals aged 15 to 25.
The effort brings together UCI faculty, clinicians, students, researchers, and community partners. It is co-led by Jason Schiffman, UCI professor of psychology and associate dean for research and faculty welfare for the School of Social Ecology, and Dr. Cameron S. Carter, UCI Distinguished Professor and chair of psychiatry and human behavior. The program aims to address a significant need, as research suggests 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 indicates thousands of young people could benefit from specialized assessment and support, according to Schiffman.
Over the grant period, the program intends to provide treatment and coordinated care to more than 150 young people. Additionally, 500 to 600 brief screenings are expected each year, with outreach efforts extending to families, schools, health care providers, and community organizations. Disorders involving psychosis, which can include hallucinations, delusions, and disorganized thinking, often first emerge during adolescence and young adulthood. Researchers have recognized a critical period before a first full episode when symptoms are developing but have not yet crossed a clinical threshold, Schiffman noted.
Reaching young people during this window has historically been challenging. 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 something feels different but struggle to articulate it or fear reactions from others. Stigma also presents a significant barrier, and available services have often been fragmented. The program seeks to overcome these hurdles by creating a clear, connected system.
Psychosis risk can undermine crucial developmental milestones such as forming friendships, earning degrees, and starting careers, long before a formal episode occurs, Schiffman said. He added that the initiative provides a chance to address distress, support families, and help young people remain engaged in their lives in ways consistent with their own values and passions. If psychosis does develop, the program aims for specialized treatment to begin promptly.
The program is designed to integrate into young people's existing support networks. A school counselor who observes a student becoming withdrawn, or a pediatrician noting an inexplicable decline in a patient’s grades, can initiate a referral into the system. Following a referral, a brief screening questionnaire is administered. A positive result then leads to a structured clinical interview conducted by a trained UCI clinician. From this point, the young person is matched to appropriate care.
Care options include cognitive behavioral therapy for many individuals, psychiatric consultation for those with more severe symptoms, and supported education and employment programs for interested participants. 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 do not seem to make sense, Schiffman advises seeking help. He emphasized 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, as 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 deserve support, and the program is available to help.
For those individuals who do go on to experience psychosis, the connection to specialty care is already established, Schiffman and Carter pointed out. Schiffman explained that if a first episode of psychosis occurs, the team is already in place to help coordinate that transition and connect families with others undergoing similar experiences. This grant formalizes years of groundwork for Schiffman, who co-founded Thrive Together OC in 2021 and has trained more than 1,000 Orange County providers. He hopes this funding will build services that will endure beyond the four-year grant period. UCI’s research has already influenced national guidelines for early psychosis intervention, impacting programs beyond Orange County. Schiffman believes the challenge lies not in a shortage of resources, but in establishing clear referral pathways, shared training, and coordination to create an effective system.
