“In late adolescence, my daughter, Anne, began to exhibit some odd and alarming behaviour. It began with voices in her head that commanded her to do things. The voices commented on everything she did, even on her thoughts. Anne began to believe her thoughts weren’t her own. She believed she had special powers like telepathy, and reported seeing auras. Several times, she tried to kill herself.
At 21, she was no longer able to hold down a job, and spent her days at home. I was distraught, yet powerless to help.
Then one day, her doctor read about a specialized program for early psychosis at the Douglas called PEPP-Montreal (Prevention and Early Intervention Program for Psychoses) . One of the clinician-researchers was making a presentation to other doctors. On a hunch, he attended. He learned that psychotic disorders are treatable, provided they’re caught and treated early. The longer the delay, the poorer the outcome. He immediately sent Anne there.
PEPP-Montreal promises to assess any new patient within 72 hours of referral. With Anne, they did even better. They saw her within 24 hours and immediately accepted her for treatment.
Anne has since made tremendous strides. She takes medication and receives a range of supports, including individual and family therapy. She has a full-time job and the voices have receded. Best of all, Anne is eager to participate in the recovery of others and tells her story to new patients at PEPP-Montreal.”
Early Intervention in Psychosis and Schizophrenia
“It is becoming increasingly clear that there are limits to what can be done to reduce the impact of mental illness through treatment alone. Recent findings illustrate just how important it is to prevent people, wherever possible, from developing a mental illness in the first place.”
-Mental Health Commission of Canada, November 2009
A chronic and highly complex disorder caused by chemical imbalances in the brain, schizophrenia represents the most disturbing face of mental illness, long associated with street people and the homeless. Schizophrenia patients currently occupy more hospital beds in Canada than any other medical or surgical condition.
Despite popular perceptions to the contrary, the disease is highly treatable, provided there is early detection and continued treatment. The Douglas provides the widest range of accepted treatments for schizophrenia. Since most people with schizophrenia are not diagnosed early enough, and get inadequate treatment, their average lifespan is 25 years less than the general population. This is a devastating indictment on our society.
Douglas pioneers a new approach
Led by Ashok Malla, MD, FRCPC, a Douglas team is pioneering an approach that mobilizes psychiatry, genetics, epidemiology, and brain imaging in the largest longitudinal study and treatment program of its kind in Canada. The Douglas team’s unique approach strives to:
• Integrate prevention with research into a single program – Prevention and Early Intervention Program for Psychoses (PEPP). PEPP sees clients without referral and in less than 72 hours.
• Target youth and focus services on ultra-high risk individuals, since 75% of people with schizophrenia have their first onset of psychotic symptoms at an early age. If these episodes are managed, the patient may never develop schizophrenia.
• Find early markers for schizophrenia and thereby concentrate resources where they can have the greatest impact on society and individuals.
• Encourage family involvement, which is key to improved outcomes.
• Standardize best practices at Montreal hospitals, teach skills of early identification at community health clinics, high schools and CEGEPs, and recruit at-risk youth for study and treatment.
Prevention and Early Intervention Program for Psychosis (PEPP-Montréal)